Pulmonology Book

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Pulmonary Embolism Rule-Out Criteria

Aka: Pulmonary Embolism Rule-Out Criteria, PERC Rule
  1. See Also
    1. Pulmonary Embolism
    2. Pulmonary Embolism Diagnosis
    3. Pulmonary Embolism Pretest Probability (Wells Clinical Prediction Rule for PE)
    4. Pulmonary Embolism Low Probability Evaluation
    5. Pulmonary Embolism Moderate Probability Evaluation
    6. Pulmonary Embolism High Probability Evaluation
    7. Wells Clinical Prediction Rule for PE
  2. Indications
    1. Evaluation of Pulmonary Embolism in patients clinically assessed as low probability (likelihood up to 10%)
      1. Based on Pulmonary Embolism Pretest Probability (Wells Clinical Prediction Rule for PE)
  3. Criteria: Assumes a low clinical suspicion for PE
    1. Age <50 years
    2. Heart Rate <100 bpm
    3. Oxygen Saturation >94%
    4. No unilateral Leg Swelling
    5. No Hemoptysis
    6. No surgery or Trauma within 4 weeks
    7. No prior DVT or PE
    8. No hormone use
      1. Includes oral, transdermal and intravaginal Estrogens as well as some Progestins
  4. Interpretation
    1. Low clinical suspicion for PE and all criteria negative (see above)
      1. Reasonable to forego further testing for Pulmonary Embolism
    2. Indications for further evaluation
      1. Any PERC criteria positive or
      2. Moderate to High Clinical Suspicion for Pulmonary Embolism (>10% likelihood)
  5. References
    1. Kline (2004) J Thromb Haemost 2(8): 1247-55 [PubMed]

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