
Which of the following is the best course of action to further evaluate for a diagnosis of pulmonary embolism?
- A) Perform a V/Q scan
- B) Draw a D-Dimer test
- C) Perform a CT Pulmonary Angiogram
- D) Give lorazepam
Wells’ Criteria for Pulmonary Embolism
Criteria | Point Value |
---|---|
Clinical signs and symptoms of DVT | +3 |
PE is #1 diagnosis, or equally likely | +3 |
Heart rate > 100 | +1.5 |
Immobilization at least 3 days, or Surgery in the Previous 4 weeks | +1.5 |
Previous, objectively diagnosed PE or DVT | +1.5 |
Hemoptysis | +1 |
Malignancy w/ Treatment within 6 mo, or palliative | +1 |
Score >4 = High probability
Score 2–4 = Moderate probability
Score <2 = Low probability
Pulmonary Embolism Rule Out Criteria
All Variables Must Be Present for <2% Chance of PE |
---|
Pulse oximetry >94% (room air) |
HR <100 |
No prior PE or DVT |
No recent surgery or trauma within prior 4 wk |
No hemoptysis |
No estrogen use |
No unilateral leg swelling |
Which of the following is the best course of action to further evaluate for a diagnosis of pulmonary embolism?
— iem-student (@iem_student) October 2, 2020
References
Wieters J, McDonough J, Catral J. Chest Pain. In: Stone C, Humphries RL. eds. CURRENT Diagnosis & Treatment: Emergency Medicine, 8e. McGraw-Hill; Accessed August 17, 2020. https://accessmedicine.mhmedical.com/content.aspx?bookid=2172§ionid=165059275
Nickson, C. (2019). Pulmonary Embolism. Life in the Fastlane. Accessed on August 17, 2020. https://litfl.com/pulmonary-embolism/
You may want to read these
Pulmonary Embolism – https://iem-student.org/pulmonary-embolism/
Clinical Decision Rules – https://iem-student.org/clinical-decision-rules/
Question of The Day #6 – https://iem-student.org/2020/07/31/question-of-the-day-6/
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