Pulmonary Embolus – PERC Rule (PE)

Decision

Rule out PE

Population

Clinic and Hospital

Components

Age < 50 years «•»
Pulse < 100 beats min «•»
SaO2 >or= 95% «•»
No hemoptysis «Y» «N»
No oral hormone use «Y»«N»
No surgery/trauma «Y» «N»
No prior DVT or PE«Y» «N»
No unilateral leg swelling «Y» «N»

Score

Pulmonary embolism can be ruled out clinically if none of the 8 PERC criteria are present in a patient with a low pretest probability of PE (e.g. Wells PE CPG score of

Reference

Carpenter CR, et al (2009). Differentiating low-risk and no-risk PE patients: the PERC score. J Emerg Med, 36 (3), 317-22 PMID: 19097732

Durieux P, et al. D-dimer testing as the initial test for suspected pulmonary embolism. Appropriateness of prescription and physician compliance to guidelines. Thromb Res 2001;101:261–6 PMID: 11248287

Kline JA, et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. Aug 2004;2(8):1247-1255. PMID: 15304025

Kline JA, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haem 2008 May;6(5):772-80. Epub 2008 Mar 3. PMID: 18318689

Fields JM, Goyal M. Venothromboembolism. Emerg Med Clin North Am. Aug 2008;26(3):649-683, viii. PMID: 18655939

Wolf SJ, et al. Assessment of the pulmonary embolism rule-out criteria rule for evaluation of suspected pulmonary embolism in the emergency department. Am J Emerg Med. Feb 2008;26(2):181-185. PMID: 18272098