2020 NICE guidelines (pulmonary embolism)
All patients with symptoms or signs suggestive of a PE should have a history taken, examination performed and a chest x-ray to exclude other pathology.
NICE updated their guidelines on the investigation and management of venous thromboembolism (VTE) in 2020. One of the key changes was the use of the pulmonary embolism rule-out criteria (the PERC rule)
a link is provided to PERC rule in the external link section
this should be done when you think there is a low probability of PE, but want more reassurance that it isn’t the diagnosis
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NICE define this low probability as < 15%, although it is clearly difficult to quantify such judgements
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if your suspicion of PE is greater than this then you should move straight to the 2-level PE Wells score, without doing a PERC
If a PE is suspected a 2-level PE Wells score should be performed: