Hematology

Check out the best practices at: http://annals.org/article.aspx?articleid=2443959

ACP Best Practices for Pulmonary Embolism:

1. Use validated clinical prediction rules to estimate pretest probability
2. Do not obtain D Dimer or imaging in patients with low pretest probability of PE and meet PERC RO criteria
3. Get a D Dimer, and NOT imaging in:
   1. Moderate pretest probability
   2. Low pretest probability who do not meet all PERC rule out criteria
4. Use age adjusted D dimer thresholds in patients >50yo
   1. Calculation: Age x 10ng/mL
5. Do not get imaging in patients with D Dimer below age adjusted cutoff
6. If high pretest probability, then:
   a. Get CT angio pulm arteries
   b. V-Q scan if cannot get CTPA
   c. Do not get D Dimer