DVT complete diagnostic approach resident survival guide: Difference between revisions

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{{familytree/start}}
{{familytree/start}}
{{familytree | | | | | | | A01 | | | | | | | | | | | | | | | | | A02 |  A01= Suspected high-risk PE}}
{{familytree | | | | | | | A01 | | | | | | | | | | | | | | | | | A02 |  A01= Suspected high-risk PE| A02= Suspected non-high risk PE}}
{{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | B01 | | | | | | | | | | | | | | | | | B02| B01= Is a CT available immediately?}}
{{familytree | | | | | | | B01 | | | | | | | | | | | | | | | | | B02| B01= Is a CT available immediately?| B02= What is the pretest probability of PE?}}
{{familytree | | | |,|-|-|-|^|-|-|-|-|-|-|-|.| | | | | | | |,|-|-|^|-|-|.| | }}
{{familytree | | | |,|-|-|-|^|-|-|-|-|-|-|-|.| | | | | | | |,|-|-|^|-|-|.| | }}
{{familytree | | | C01 | | | | | | | | | | C02 | | | | | | |!| | | | | |!| | C01= No| C02= Yes}}
{{familytree | | | C01 | | | | | | | | | | C02 | | | | | | |!| | | | | |!| | C01= No| C02= Yes}}
Line 8: Line 8:
{{familytree | | | D01 | | | | | | | | | | |!| | | | | | | |!| | | | | |!| | D01= Order [[echocardiography]]}}
{{familytree | | | D01 | | | | | | | | | | |!| | | | | | | |!| | | | | |!| | D01= Order [[echocardiography]]}}
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | | |!| | | | | |!| | }}
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | | |!| | | | | |!| | }}
{{familytree | | | E01 | | | | | | | | | | |!| | | | | | | E02 | | | | E03 |  E01= Does the patient have RV overload?}}
{{familytree | | | E01 | | | | | | | | | | |!| | | | | | | E02 | | | | E03 |  E01= Does the patient have RV overload?| E02= Low/intermediate pretest probability <br>OR<br> PE is unlikely| E03= High pretest probability <br>OR<br> PE is likely}}
{{familytree | |,|-|^|-|-|-|.| | | | | | | |!| | | | | | | |!| | | | | |!| | }}
{{familytree | |,|-|^|-|-|-|.| | | | | | | |!| | | | | | | |!| | | | | |!| | }}
{{familytree | F01 | | | | F02 | | | | | | F03 | | | | | | F04 | | | | |!| F01= No| F02= Yes| F03= Order CT}}
{{familytree | F01 | | | | F02 | | | | | | F03 | | | | | | F04 | | | | |!| F01= No| F02= Yes| F03= Order CT| F04= Order D-dimer}}
{{familytree | |!| | | | | |!| | | | | |,|-|^|-|.| | | |,|-|^|-|.| | | |!| }}
{{familytree | |!| | | | | |!| | | | | |,|-|^|-|.| | | |,|-|^|-|.| | | |!| }}
{{familytree | |!| | | | | |!| | | | | G02 | | G03 | | G04 | | G05 | | |!| G01= | G02= Positive for PE| G03= Negative for PE}}
{{familytree | |!| | | | | |!| | | | | G02 | | G03 | | G04 | | G05 | | |!| G01= | G02= Positive| G03= Negative| G04= Negative| G05= Positive}}
{{familytree | |!| | | |,|-|^|-|.| | | |!| | | |!| | | |!| | | |!| | | |!| }}
{{familytree | |!| | | |,|-|^|-|.| | | |!| | | |!| | | |!| | | |!| | | |!| }}
{{familytree | |!| | | H01 | | H02 | | |!| | | |!| | | H03 | | H04 | | H05 | | | H01= Is the patient unstable <br> OR<br> no other tests are available?| H02=Is the patient stabilized <br> AND <br> CT is now available?}}
{{familytree | |!| | | H01 | | H02 | | |!| | | |!| | | H03 | | H04 | | H05 | | | H01= Is the patient unstable <br> OR<br> no other tests are available?| H02=Is the patient stabilized <br> AND <br> CT is now available?| H03= PE is excluded| H04= Order CT| H05= Order CT}}
{{familytree | |!| | | |!| | | |!| | | |!| | | |!| | | |,|-|-|-|(| | | |)|-|-|-|.| | }}
{{familytree | |!| | | |!| | | |!| | | |!| | | |!| | | |,|-|-|-|(| | | |)|-|-|-|.| | }}
{{familytree | I01 | | I02 | | I03 | | I04 | | I05 | | I06 | | I07 | | I08 | | I09 | I01= PE is excluded| I02= Consider thrombolysis or embolectomy| I03= Order CT| I04= PE is confirmed| I05=PE is excluded}}
{{familytree | |!| | | |!| | | |!| | | |!| | | |!| | | L01 | | L02 | | L03 | | L04 | L01= Negative| L02= Positive| L03= Negative| L04= Positive}}
{{familytree | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | }}
{{familytree | I01 | | I02 | | I03 | | I04 | | I05 | | I06 | | I07 | | I08 | | I09 | I01= PE is excluded| I02= Consider thrombolysis or embolectomy| I03= Order CT| I04= PE is confirmed| I05=PE is excluded| I06= PE is excluded| I07= PE is confirmed| I08= PE is excluded| I09= PE is confirmed}}
{{familytree | | | | | | | |,|-|^|-|.| | | | }}
{{familytree | | | | | | | |,|-|^|-|.| | | | }}
{{familytree | | | | | | | J01 | | J02 | | | J01= Positive for PE| J02= Negative for PE}}
{{familytree | | | | | | | J01 | | J02 | | | J01= Positive for PE| J02= Negative for PE}}

Revision as of 15:41, 15 May 2014

 
 
 
 
 
 
Suspected high-risk PE
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Suspected non-high risk PE
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Is a CT available immediately?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
What is the pretest probability of PE?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
No
 
 
 
 
 
 
 
 
 
Yes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Order echocardiography
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does the patient have RV overload?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low/intermediate pretest probability
OR
PE is unlikely
 
 
 
High pretest probability
OR
PE is likely
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
No
 
 
 
Yes
 
 
 
 
 
Order CT
 
 
 
 
 
Order D-dimer
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Positive
 
Negative
 
Negative
 
Positive
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Is the patient unstable
OR
no other tests are available?
 
Is the patient stabilized
AND
CT is now available?
 
 
 
 
 
 
 
 
 
 
 
PE is excluded
 
Order CT
 
Order CT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Negative
 
Positive
 
Negative
 
Positive
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PE is excluded
 
Consider thrombolysis or embolectomy
 
Order CT
 
PE is confirmed
 
PE is excluded
 
PE is excluded
 
PE is confirmed
 
PE is excluded
 
PE is confirmed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Positive for PE
 
Negative for PE
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PE is confirmed
 
PE is excluded