Jeff Kline is an Emergency Medicine and Thrombosis Physician and Researcher in the USA.
He has a massive research portfolio but is perhaps most famous for the PERC Rule
We talked about if and when to pull the trigger on empiric lysis in suspected PE before definitive imagine. This could be the shocked patient or a patient in cardiac arrest
The Courtney Clinical Decision Rule:
If witnessed arrest, age <65 and initial rhythm of PEA then a 50% chance of autopsy proven PE so consider empiric lysis.
Courtney DM, Kline JA. Prospective use of a clinical decision rule to identify
pulmonary embolism as likely cause of outpatient cardiac arrest. Resuscitation.
2005 Apr;65(1):57-64. PubMed PMID: 15797276.
ECG changes to suggest massive PE:
Marchick MR, Courtney DM, Kabrhel C, Nordenholz KE, Plewa MC, Richman PB,
Smithline HA, Kline JA. 12-lead ECG findings of pulmonary hypertension occur more
frequently in emergency department patients with pulmonary embolism than in
patients without pulmonary embolism. Ann Emerg Med. 2010 Apr;55(4):331-5. doi:
10.1016/j.annemergmed.2009.07.025. Epub 2009 Sep 19. PubMed PMID: 19766353.