Patient selection: pulmonary embolism
Risk factors for a delay or missed diagnosis of an acute PE:
(1)
no obvious risk factors for PE
(2) significant comorbidity
(2a) older adult with cardiovascular disease (CHF, ischemic change, etc)
(2b) asthma, COPD or other pulmonary disease
(2c) pneumonia-like infiltrate on chest X-ray
(2d) serious trauma requiring immediate care
(2e) morbid obesity
(3) vague and nonspecific findings (pleural pain, fever, hemoptysis)
(4) high work intensity
(5) inexperience
(6) small PE
where:
• A patient with significant comorbidity may not tolerate the adverse effects of the PE. This group may be most affected if the diagnosis is not made promptly.
