PERC (Pulmonary Embolism Rule-out Criteria)

USING THE PERC RULE

Emergency Physicians Monthly 31/12/2007

Top Headlines in Clinical Emergency Medicine, (Abstracted from EM:RAP by Chris Feier, MD)

"Use of the PERC (Pulmonary Embolism Rule-out Criteria) rule can significantly decrease work-up for pulmonary embolism.
To apply this rule, the clinician must first use clinical gestalt to classify the patient as low risk. The PERC rule, which consists of eight clinical criteria including history, physical and vital signs, can then be used. If both of these criteria are met, then there is less than a 2 percent risk that this patient has a PE and no further work-up is needed."

PERC Rule
Age < 50 years
Pulse < 100 bpm
SaO2 > 94%
No unilateral leg swelling
No hemoptysis
No recent trauma or surgery
No prior PE or DVT
No hormone use

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http://www.mdcalc.com/perc-rule-for-pulmonary-embolism

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Diagnostic Accuracy of Pulmonary Embolism Rule-Out Criteria: A Systematic Review and Meta-analysis. Balwinder Singh et al. Annals of Emergency Medicine. Received 9 July 2011; revised 8 September 2011; revised 10 October 2011; Accepted 25 October 2011. Available online 15 December 2011

Conclusion: The existing literature suggests consistently high sensitivity and low but acceptable specificity of the PERC to rule out pulmonary embolism in patients with low pretest probability.

http://www.annemergmed.com/webfiles/images/journals/ymem/FA-bsingh.pdf