Document Detail


Critical issues in the evaluation and management of adult patients presenting to the emergency department with suspected pulmonary embolism.
MedLine Citation:
PMID:  21621092     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Francis M Fesmire; Michael D Brown; James A Espinosa; Richard D Shih; Scott M Silvers; Stephen J Wolf; Wyatt W Decker;
Publication Detail:
Type:  Journal Article; Practice Guideline    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  57     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-30     Completed Date:  2011-07-29     Revised Date:  2012-01-26    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  628-652.e75     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Decision Support Techniques
Emergency Service, Hospital*
Female
Fibrin Fibrinogen Degradation Products / analysis
Fibrinolytic Agents / therapeutic use
Humans
Male
Middle Aged
Pulmonary Embolism / diagnosis*,  drug therapy,  radiography,  therapy
Risk Factors
Thrombolytic Therapy
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/Fibrinolytic Agents; 0/fibrin fragment D
Investigator
Investigator/Affiliation:
Wyatt W Decker / ; Francis M Fesmire / ; Michael D Brown / ; Deborah B Diercks / ; Barry M Diner / ; Jonathan A Edlow / ; Steven A Godwin / ; Sigrid A Hahn / ; Benjamin W Hatten / ; John E Houghland / ; J Stephen Huff / ; Eric J Lavonas / ; Gail Lenehan / ; Sharon E Mace / ; Edward Melnick / ; Devorah J Nazarian / ; AnnMarie Papa / ; Susan B Promes / ; Richard D Shih / ; Scott M Silvers / ; Edward P Sloan / ; Stephen J Wolf / ; David C Seaberg / ; Robert E O'Connor / ; Rhonda R Whitson /
Comments/Corrections
Comment In:
Ann Emerg Med. 2012 Jan;59(1):84-5   [PMID:  22177687 ]

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