It is the position of the American Academy of Emergency Medicine that, when properly applied to an individual patient for whom the clinician already has a low clinical suspicion for PE, based on a gestalt impression, the Pulmonary Embolism Rule-Out Criteria (PERC) meets the standard of care for EM. When a patient is PERC negative no further diagnostic work up for pulmonary embolism is required including D-dimer measurement and the performance of advanced imaging studies (CT pulmonary angiography and VQ scanning).
References:
- Kline JA, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost 2008; 6:772-80.
- Singh B, et al. Diagnostic accuracy of pulmonary embolism rule-out criteria: A systematic review and meta-analysis. Ann Emerg Med 2012; 59: 517-20.
Approved: 2/21/14