{"id":4351,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/pulmonaryembolism-suspected\/"},"modified":"2023-09-13T15:45:52","modified_gmt":"2023-09-13T14:45:52","slug":"pulmonaryembolism-suspected","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/pulmonaryembolism-suspected\/","title":{"rendered":"Pulmonary Embolism – Suspected"},"content":{"rendered":"\nPulmonary Embolism – Suspected<\/title>\n\n\n\n<h3 class=\"wp-block-heading\">\u200bServices<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Royal Infirmary of Edinburgh<\/li>\n\n\n\n<li>Western General Hospital<\/li>\n\n\n\n<li>St John’s Hospital<\/li>\n<\/ul>\n\n\n\n<p><strong>All suspected cases of pulmonary embolism should be referred for assessment <\/strong>which will include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>assessment of clinical probability<\/li>\n\n\n\n<li>blood tests (D-dimer)<\/li>\n\n\n\n<li>CXR<\/li>\n\n\n\n<li>CT pulmonary angiogram (CPTA) or radio isotope lung perfusion.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p><strong>Clinical patterns of pulmonary embolism:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>sudden collapse with raised jugular venous pressure (faintness and\/or hypotension)<\/li>\n\n\n\n<li>pulmonary infarction syndrome (pleuritic pain and\/or haemoptysis)<\/li>\n\n\n\n<li>isolated breathlessness or tachypnoea (respiratory rate >20 (ie no cough\/sputum\/chest pain)<\/li>\n<\/ul>\n\n\n\n<p><strong>Consider pulmonary embolism with these clinical patterns<\/strong>  <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>in the absence of another clinical explanation<\/li>\n\n\n\n<li>in the presence of a major risk factor<\/li>\n<\/ul>\n\n\n\n<p><strong>Major risk factors<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>recent immobilisation or major surgery<\/li>\n\n\n\n<li>recent lower limb trauma and\/or surgery<\/li>\n\n\n\n<li>clinical deep vein thrombosis<\/li>\n\n\n\n<li>previous proven DVT or pulmonary embolism<\/li>\n\n\n\n<li>pregnancy or post-partum<\/li>\n\n\n\n<li>major medical illness<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>patients with symptoms who clearly have clinical signs indicating another explanation e.g. chest infection<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>refer via SCI-Gateway<\/li>\n\n\n\n<li>urgent same-day referral to the nearest hospital<\/li>\n\n\n\n<li>GPs should not give any specific treatment on referral<\/li>\n\n\n\n<li>if a massive pulmonary embolism is suspected the patient should be given high dose oxygen only.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Respiratory-PE-Patient-Info-Document-August-2020.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Respiratory-PE-Patient-Info-Document-August-2020.pdf\" target=\"_blank\">Respiratory-PE- Patient Info Document August 2020<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Respiratory-Lothian-COPD-Guidance-April-2018-v0-4-Combined-2-1.pdf\" data-type=\"attachment\" data-id=\"10030\" target=\"_blank\" rel=\"noreferrer noopener\">Lothian COPD Guidance April 2018 v0 4 Combined<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nice.org.uk\/\" data-type=\"URL\" data-id=\"https:\/\/www.nice.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Institute for Health and Care Excellence (NICE)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.sign.ac.uk\/\" data-type=\"URL\" data-id=\"https:\/\/www.sign.ac.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Intercollegiate Guidelines Network (SIGN)<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Pulmonary Embolism – Suspected ​Services All suspected cases of pulmonary embolism should be referred for assessment which will include:<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4381,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[606],"class_list":["post-4351","page","type-page","status-publish","hentry","category-pulmonaryembolism-suspected"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/respiratory\/pulmonaryembolism-suspected\/\" rel=\"tag\">Pulmonary Embolism - Suspected<\/a>","rttpg_excerpt":"Pulmonary Embolism – Suspected ​Services All suspected cases of pulmonary embolism should be referred for assessment which will include:","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4351","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4351"}],"version-history":[{"count":6,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4351\/revisions"}],"predecessor-version":[{"id":14351,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4351\/revisions\/14351"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4381"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4351"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4351"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}