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PERC rule for Pulmonary Embolism


The Pulmonary Embolism Rule-out Criteria (PERC) helps assess people in whom pulmonary embolism is suspected, but unlikely.

In 2004, Kline et al [1] derived the pulmonary embolism rule-out criteria (PERC), an eight-factor decision rule to support the decision not to order a diagnostic test for PE in patients for whom the clinician already had a low clinical suspicion for PE based on a gestalt impression. The PERC criteria negative [PERC(−)] requires the clinician to answer ‘no’ to the following eight questions:

PERC rule for Pulmonary Embolism

Is the patient older than 49 years of age?

Is the pulse oximetry reading <95% while the patient breaths room air?

Tachycardia (heart rate over 99 bpm)?

Is the patient taking exogenous estrogen?

History of venous thromboembolism (VTE)?

Is there a present history of hemoptysis

Does the patient have unilateral leg swelling? (Visual observation of asymmetry of the calves.)
Has the patient had recent surgery or trauma? (Requiring endotracheal intubation or hospitalization in the previous 4 weeks.)

KLINE, J. A., COURTNEY, D. M., KABRHEL, C., MOORE, C. L., SMITHLINE, H. A., PLEWA, M. C., RICHMAN, P. B., O'NEIL, B. J. and NORDENHOLZ, K. (2008), Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. Journal of Thrombosis and Haemostasis, 6: 772–780. doi:10.1111/j.1538-7836.2008.02944.x

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