smalley
Forum Elite
Topics: 51
Posts: 284
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what is the order of diag tests in suspected pulmonary embolism
to start with chest xray,arterial blood gases ,ekg followed by v/q scan or to directly begin with v/q scan
thanks
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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
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| hir
Forum Elite
Topics: 2
Posts: 344
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go in the same order u have mentioned.....u can go for v/q scan directly if cxray,ABG, EKG has been given in que stem
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| peter90036
Forum Elite
Topics: 28
Posts: 315
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Wells criteria algorithm says :
si/s dvt: leg pain, swelling etc = 3 points
an alternate diagnosis is less likely than PE = 3points
HR>100 = 1.5
immobilization/surgery in previous 4wks = 1.5
previous PE/DVT = 1.5
hemoptysis = 1
malignancy = 1
high probability = score > 4
---> imaging:
--------------> CT (not all institution can do, not in renal dz or contrast-iodine allergy)
--------------> VQ
low probability = score <4 --> DDimer
also see this:
NEJM Volume 358:1037-1052 March 6, 2008 Number 10
Acute Pulmonary Embolism
clinical suspicion:
- low/moderate ---> elisa DDimer = Norm=no tx // DDimer = abnormal ----> CXR
- high -------------------------------- consider start tx ------------------------------> CXR
CXR abnormal ---> chest CT arteriography
CXR normal ------> CT or VQ
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| Janka
Forum Senior
Topics: 28
Posts: 146
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uw says essentially same order of dx tests as you mentioned in the first place, but ! if you are presented with a vignette where the clinical picture, abg, cxr, ekg all together give a high index of suspicion and the question is what is the most appropriate next step, be sure to choose heparin therapy over v/q scan!
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| smalley
Forum Elite
Topics: 51
Posts: 284
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thanks all
___________________
But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
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