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Practice Guideline
. 2011 Jun;57(6):628-652.e75.
doi: 10.1016/j.annemergmed.2011.01.020.

Critical issues in the evaluation and management of adult patients presenting to the emergency department with suspected pulmonary embolism

Francis M Fesmire, Michael D Brown, James A Espinosa, Richard D Shih, Scott M Silvers, Stephen J Wolf, Wyatt W Decker; American College of Emergency Physicians
Collaborators
Practice Guideline

Critical issues in the evaluation and management of adult patients presenting to the emergency department with suspected pulmonary embolism

Francis M Fesmire et al. Ann Emerg Med. 2011 Jun.

Abstract

This clinical policy from the American College of Emergency Physicians is the revision of a 2003 clinical policy on the evaluation and management of adult patients presenting with suspected pulmonary embolism (PE).(1) A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1) Do objective criteria provide improved risk stratification over gestalt clinical assessment in the evaluation of patients with possible PE? (2) What is the utility of the Pulmonary Embolism Rule-out Criteria (PERC) in the evaluation of patients with suspected PE? (3)What is the role of quantitative D-dimer testing in the exclusion of PE? (4) What is the role of computed tomography pulmonary angiogram of the chest as the sole diagnostic test in the exclusion of PE? (5) What is the role of venous imaging in the evaluation of patients with suspected PE? (6) What are the indications for thrombolytic therapy in patients with PE? Evidence was graded and recommendations were given based on the strength of the available data in the medical literature.

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Comment in

  • More on the PERC rule.
    Kline JA. Kline JA. Ann Emerg Med. 2012 Jan;59(1):84-5. doi: 10.1016/j.annemergmed.2011.07.041. Ann Emerg Med. 2012. PMID: 22177687 No abstract available.

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