What is the panic value?: A discussion on a contemporary  version of panic value

Abstract

The concept of the panic value dates back to 1972 when Lundberg defined. It is not merely a value defined by laboratory test results, but is a system based on which medical staffs have to act. Once an extreme value, that is the test result significantly ranged out from its reference interval, is obtained, its accuracy is guaranteed, a variety of possible errors in a clinical laboratory is ruled out, and it must be reported to the physicians as the panic value as soon as possible. Not only the panic values list but also its reporting system need to be established after several consultations between the clinical laboratory technologists and the physicians. Most of the recent medical accidents relating to the panic values are caused by the fails in the reporting system, as Lundberg already mentioned in 1972. Therefore, his concept is still essential in our time. On the other hand, the panic value must take on new changes depending on the standardization in primary care, the introduction of POCT (point of care testing) in emergency medicine, and the certification of ISO15189 in clinical laboratory. The future management on the panic value will require education and share of medical expertise as well as much closer communication between the physicians and medical staffs such as clinical laboratory technologists.