Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Suspected Pulmonary Embolism
2011; Elsevier BV; Volume: 57; Issue: 6 Linguagem: Inglês
10.1016/j.annemergmed.2011.01.020
ISSN1097-6760
AutoresFrancis M. Fesmire, Michael D. Brown, James Espinosa, Richard D. Shih, Scott M. Silvers, Stephen J. Wolf, Wyatt W. Decker,
Tópico(s)Ultrasound in Clinical Applications
ResumoThis 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).1American College of Emergency PhysiciansClinical policy: critical issues in the evaluation and management of patients presenting with suspected pulmonary embolism.Ann Emerg Med. 2003; 41: 257-270Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar 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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