Wildest lab values you've ever seen?

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I was just wondering what's the most off the chart lab values (true values, not lab screw ups) that you'd encountered where the patient lived to discharge? I've seen:

Hgb 2.8 -- we just about emptied the blood bank.

PTT > 240

PT > 120

INR > 10

Specializes in Orthopaedics.

Pt recently with ammonia over 440... Still in CCU, ten days on...

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Specializes in med-surg, psych, ER, school nurse-CRNP.

K+ 1.8. I kid you not. Patient lived to tell the tale, only came in because his defibrillator fired. And while everyone was freaking over the defib going off, my question was, "With a K+ that low, anyone think THAT may have caused some arrhythmia?"

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Glucose of one.

Seriously? I'm guessing there was some major brain damage and if the 20/20 rule truly applies.

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INR 30. When i told the surgeon, he thought i meant PTT. i told him to look in the computer. "oh, we can't do surgery." really? haha. nice guy. i transfused about 4 bags of FFP. i came on that night and had the same patients. i had to transfuse another 2 bags and one unit PRBC. he had a laceration on his hand that wouldn't stop bleeding. changing his bandage every 45-60 minutes. he started getting confused after awhile. originally came in for fx right hip. he was taking coumadin and lived at a nursing home. don't they do blood draws for check ups?

WBC 220,000. when lab called i thought they said 22. i always look in the computer first before writing up the critical value and giving it to the nurse.

Hemoglobin 1.2. enough said.

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Specializes in telemetry, ortho, med-surg.
Glucose of one.

:o! Were they even conscious?

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Specializes in Oncology.
Wbc .004 - bone marrow transplant and lived.

I'm surprised that was actually recorded. Our levels just come back at

edited to add: After re-reading, was the WBC of 0.004 before they had the transplant, ie, what caused them to need a transplant? Or was it because of the pre-transplant chemo?

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Some AIDS patients have triglyceride levels that are off the charts. It's still unknown whether it's the disease process or a side effect of some of the antiretrovirals.

Highest Scr: 29. Patient died later that day.

Highest blood glucose: I've seen several over 1,500. These were new onset Type I diabetics.

Last March, my 18-year-old cat was clearly very sick, so I took her to the emergency vet, and when saw I that her SGOT and AST were both in excess of 6000, which was the highest the machine registered, I knew she was about to travel over the Rainbow Bridge, and she proceeded to do that a few hours later. :redbeathe :crying2: The vet said her blood was orange; my regular vet said she most likely had cancer with liver mets. She appeared to be healthy, although perceptibly slowing down, until the day before she died.

How about some other extremes?

Highest morphine dose: 200mg/hour. Hospice patient, and we were pulling the morphine directly out of the stock bottles and squirting it into an empty IV bag.

Grandest multipara that was believable: G18 P14 L15. She was Amish. I've seen a few women who claimed to be gravida 20-plusses but they also had psych histories.

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Specializes in Oncology.

Highest morphine dose: 200mg/hour. Hospice patient, and we were pulling the morphine directly out of the stock bottles and squirting it into an empty IV bag.

I had a patient at 130 mg/hr. I thought that was pretty extreme! She was also terminal. I wish pharmacy would have sent bags bigger than 250 mg! Order allowed me to titrate up to 400 mg/hr.

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I had a 45ish year old lady, hx IVDA with terminal lung Ca who was in the mid-400 mg/hr her last 4-5 days. Pharmacy had trouble keeping up with the supply (SNF). We prayed over her IV site that it wouldn't fail, she had no veins left.

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Specializes in OR, peds, PALS, ICU, camp, school.

K+ = 1.5 ... after replacement!

with a iCa+ = 1.? really hard to treat a low Ca AND a low K at the same time!

Mg was 0.5

Pt c/o "weakness" times a few days. Progressive. Forget what the CK was but I had never seen such bad Rhabdo in an A&O pt- no trauma, no "found on floor, last saw her 5 days ago" PERFECT NSR all night. Not so much as an isolated PVC!

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Specializes in ICU.
Originally Posted by P_RN viewpost.gif

Glucose of one.

:o! Were they even conscious?

Isn't that amazing? I saw a BG = 1 also. Verified by two separate lab draws. :lol2:

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Specializes in MICU/SICU/CVICU.

ABG: pH 7.13, pCO2 88, pO2 46, don't remember the HCO3, but it was something equally ridiculous. This patient was not intubated, by the way, and the attending didn't seem to think it was warranted because "she can open her eyes." She did, in fact, open her eyes: once, after 2 minutes of vigorous sternal rubbing. Needless to say I had her tubed mighty quick.

The patient spent a few days on the vent and later discharged home in pretty good shape. Very sweet lady.

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