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Whilst shopping in town, a 70-year-old man developed pleuritic chest pain and felt faint. When the paramedics arrived he was sat down in the shop complaining of feeling breathless. He is a non-smoker but has recently had a dry cough. He denies any other symptoms or any past medical history of note.
His observations on arrival at the Emergency Department are as follows:
Pulse 110 beats per minute
BP 150/90 mmHg
Temperature 37.3°C
SpO2 93% on room air
Examination reveals normal heart sounds, a clear chest, a soft non-tender abdomen and both femoral pulses are easily palpated.
Further questioning reveals that this gentleman is previously fit and well and has had no recent surgery or immobilisation. His cough has been dry. He does not complain of leg pain or swelling and has not previously had either a PE or a DVT.
Using the Wells' criteria for risk stratification, what is this man's Wells' score?
Wells’ Criteria for risk stratifying a patient with a possible PE | |
Clinically suspected DVT | 3.0 |
PE at least as likely or more likely than alternative diagnosis | 3.0 |
Pulse rate >100 | 1.5 |
Immobilisation > 3 days | 1.5 |
Surgery last 4 weeks | 1.5 |
Previous VTE | 1.5 |
Haemoptysis | 1.0 |
Malignancy | 1.0 |
Subsequent management of this case should include which of the following?