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The Emergency Medicine Approach To The Evaluation And Treatment Of Pulmonary Embolism

December 2012

Abstract

Each year in the United States, up to 900,000 individuals will suffer from acute pulmonary embolism, resulting in an estimated 200,000 to 300,000 hospital admissions. Despite decades of research on the topic, the diagnosis remains elusive in many situations and the fatality rate remains significant. This issue presents a review of the current evidence guiding the emergency medicine approach to the diagnosis and treatment of pulmonary embolism. Key to this approach is the concept of risk stratification: using factors from the history and physical examination, plus ancillary tests, to guide clinical decision making. The pathophysiology of pulmonary embolism and decision-support tools are reviewed, and emergency department management strategies are described.

Keywords: pulmonary embolism, venous thromboembolism, deep vein thrombosis, Geneva Score, Wells Criteria, PERC rule, PESI, clinical pathway for pulmonary embolism, reperfusion treatment, inferior vena cava filters, IVC filters, thrombolytic therapy for pulmonary embolism

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