Please note: this guideline has exceeded its review date and is currently under review by specialists. Exercise caution in the use of the clinical guideline.
| Perform D-dimer and troponin |
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Revised Geneva predictive risk score (table 2): Low risk (score 0-3) – see here Intermediate risk (score 4-10) – see here High risk (score ≥11) – continue below |
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| Administer LMWH treatment dose and continue below. |
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CTPA If this is not readily available and patient is clinically stable with normal CXR and no underlying lung disease, then V/Q scan may be an alternative diagnostic option. |
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No PE – further investigation for PE may be indicated. PE present – commence apixaban or warfarin and continue below. |
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| Risk stratify according to troponin and RV size (from CTPA or by echo). |
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RV normal, troponin normal – low 30-day mortality. Consider early discharge and OP management. RV dilated, troponin normal – intermediate 30-day mortality. RV dilated or RV thrombus and troponin elevated – high 30-day mortality. |
