Emergency Medicine articles covering diagnosis, lab studies, imaging, procedures, prehospital care, emergency department care, prognosis, follow-up.
Paucis Verbis: Pulmonary Embolism Clinical Prediction Rules
"Should I get a D-Dimer test or CT chest angiogram on my patient with atypical chest pain to rule-out a pulmonary embolism?" This is a common question asked by emergency physicians on a routine basis.
Here are 3 clinical prediction rules: PERC, Wells, and Simplified Geneva Score. Personally, I've never used the Geneva Score, but it's worth looking at.
NOTE: These rules should be used with caution, because none of these scoring protocols are perfect. For instance, in a very recent publication in the Journal of Thrombosis and Haemostasis, the authors found that the PERC rule does not actually safely exclude PEs. Big bummer for us clinicians.
Thanks to Dr. Kit Tainter (Mount Sinai PGY-4 EM resident) for coming up with the idea for this card!