Pulmonary Embolism (Deep Dive MW R16‪)‬ EM Clerkship

Diagnosing PE:







Step 1: Consciously consider the diagnosis







Step 2: Risk Stratify into low, intermediate, and high risk







Step 3: Choose appropriate testing based on pre-test probability







Classification of PE









* High Risk/Massive PE: Hemodynamic Instability







* Intermediate Risk/Submassive PE: Right Heart Strain without instability ; or PESI Class 3+







* Low Risk/Non-Massive PE: Everything else (no instability, no heart strain, PESI Class 1-2)









Treatment of PE









* High Risk/Massive PE: Thrombolytics and often thrombectomy







* Intermediate Risk/Submassive PE: Heparin and sometimes intervention







* Low Risk/Non-Massive PE: Either discharge with DOAC or admit with heparin