Services
- Royal Infirmary of Edinburgh
- Western General Hospital
- St John’s Hospital
All suspected cases of pulmonary embolism should be referred for assessment which will include:
- assessment of clinical probability
- blood tests (D-dimer)
- CXR
- CT pulmonary angiogram (CPTA) or radio isotope lung perfusion.
Who to refer:
Clinical patterns of pulmonary embolism:
- sudden collapse with raised jugular venous pressure (faintness and/or hypotension)
- pulmonary infarction syndrome (pleuritic pain and/or haemoptysis)
- isolated breathlessness or tachypnoea (respiratory rate >20 (ie no cough/sputum/chest pain)
Consider pulmonary embolism with these clinical patterns
- in the absence of another clinical explanation
- in the presence of a major risk factor
Major risk factors
- recent immobilisation or major surgery
- recent lower limb trauma and/or surgery
- clinical deep vein thrombosis
- previous proven DVT or pulmonary embolism
- pregnancy or post-partum
- major medical illness
Who not to refer:
- patients with symptoms who clearly have clinical signs indicating another explanation e.g. chest infection
How to refer:
- refer via SCI-Gateway
- urgent same-day referral to the nearest hospital
- GPs should not give any specific treatment on referral
- if a massive pulmonary embolism is suspected the patient should be given high dose oxygen only.
