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| {{Pulmonary embolism}}
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| {{CMG}}
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| '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
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| ==Overview==
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| '''Pulmonary embolism''' (PE) is a potentially lethal condition, with a mortality rate close to 30 percent without treatment. Thus prompt and effective therapy is utmost important. In most cases, [[anticoagulant]] therapy is the mainstay of treatment. Acutely, supportive treatments, such as [[oxygen]] or [[analgesia]], are often required.
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| ==Treatment Algorithm==
| | {| class=wikitable border=1 |
| {{familytree/start |summary=PE treatment Algorithm.}} | | !Examples of prediction rules |
| {{familytree | | | | | | | | GMa | GMa='''Stabilize the patient'''}}
| | ! |
| {{familytree | | | | | | | | |!| }}
| | |- |
| {{familytree | | | | | | | | GPa | GPa='''Is [[anticoagulation]] contraindicated ?'''}}
| | |Active cancer (treatment within last 6 months or palliative) |
| {{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }}
| | |style="text-align:center"|1 |
| {{familytree | | |JOE| | | | | | | |SIS| | | JOE='''Yes'''|ME=Inconclusive study|SIS='''No'''}}
| | |- |
| {{familytree | | | |!| | | | | | | | | |!| }}
| | |Calf swelling >3 cm compared to other calf (measured 10 cm below tibial tuberosity) |
| {{familytree | | |MOM| | | | | | | | SIS | | |MOM=[[Pulmonary embolism diagnosis|'''Diagnostic evaluation''']]|SIS=Anticoagulate with SC [[LMWH]] or IV [[Heparin|UFH]]}}
| | |style="text-align:center"|1 |
| {{familytree | |,|-|^|.| | | | | | | | |!| }}
| | |- |
| {{familytree |GPa| |JOE| | | | | |A01|GPa=PE excluded|JOE='''PE confirmed'''|A01=[[Pulmonary embolism diagnosis|'''Diagnostic evaluation''']]}}
| | |Collateral superficial veins (non-varicose) |
| {{familytree | |!| | | |!| | | | | |,|-|^|.| }}
| | |style="text-align:center"|1 |
| {{familytree |C01| |C02| | |C03| |C04|C01=No further Treatment|C02='''[[Inferior vena cava filter#Pulmonary embolism inferior vena cava filter|Inferior vena cava filter]]'''|C03=PE excluded|C04='''PE confirmed'''}}
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| {{familytree | | | | | | | | | | |!| | | |!|}}
| | |Pitting edema (confined to symptomatic leg) |
| {{familytree | | | | | | | | | |SIS| |B02|SIS='''Discontinue Anticoagulants'''|B02='''Clinicaly severe enough to need [[Thrombolysis]]'''}}
| | |style="text-align:center"|1 |
| {{familytree | | | | | | | | | | | | |,|-|^|-|.| }}
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| {{familytree | | | | | | | | | | | |JOE| |SIS|JOE='''Yes'''|ME=Inconclusive study|SIS='''No'''}}
| | |Swelling of entire leg |
| {{familytree | | | | | | | | | | | | |!| | | |!| }}
| | |style="text-align:center"|1 |
| {{familytree | | | | | | | | | | | |SIS| |B02|SIS='''Is [[thrombolytic]] Contraindicated?'''|B02=Continue Anticoagulants}}
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| {{familytree | | | | | | | | | | |,|-|^|-|.| }}
| | |Localized pain along distribution of deep venous system |
| {{familytree | | | | | | | | |JOE| |SIS|JOE='''Yes'''|ME=Inconclusive study|SIS='''No'''}}
| | |style="text-align:center"|1 |
| {{familytree | | | | | | | | | | |!| | | |!| }}
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| {{familytree | | | | | | | | | |SIS| |B02|SIS='''[[Pulmonary thrombectomy|Surgical emblectomy]]''' or '''[[Pulmonary embolism catheter based interventions|catheter based interventions]]'''|B02='''Hold Anticoagulation, Give Thrombolytics then resume Anticoagulations'''}}
| | |Paralysis, paresis, or recent cast immobilization of lower extremities |
| {{familytree | | | | | | | | | | | | | | |!| | | |}}
| | |style="text-align:center"|1 |
| {{familytree | | | | | | | | | | | | | |SIS|SIS=Patient show Clinically Improvement}}
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| {{familytree | | | | | | | | | | | | |,|-|^|-|.| }}
| | |Recently bedridden > 3 days, or major surgery requiring regional or general anesthetic in past 12 weeks |
| {{familytree | | | | | | | | | | | |JOE| |SIS|JOE='''No'''|ME=Inconclusive study|SIS='''Yes'''}}
| | |style="text-align:center"|1 |
| {{familytree | | | | | | | | | | | | |!| | | |!| }}
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| {{familytree | | | | | | | | | | | |SIS| |B02|SIS='''[[Pulmonary thrombectomy|Surgical emblectomy]]''' or '''[[Pulmonary embolism catheter based interventions|catheter based interventions]]'''|B02=Continue Anticoagulation}}
| | |Previously documented DVT |
| {{familytree/end}}
| | |style="text-align:center"|1 |
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| [[Category:Hematology]]
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| [[Category:Pulmonology]]
| | |Alternative diagnosis at least as likely |
| [[Category:Cardiology]]
| | |style="text-align:center"| - 2 |
| [[Category:Emergency medicine]]
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| | |} |
| {{WH}}
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| {{WS}}
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