PE / DVT

Question 1

What set of criteria can determine the need for a Well’s score / CT/PA in suspected PE?

Answer 1

PERC criteria. If all are present then PE is unlikely and another diagnosis should be sought.
The criteria are;
Age <50 years
HR <100 bpm
SpO2 >95% on RA
No signs of DVT
No risk factors - surgery, pregnancy, HRT
No prior DVT / PE
No haemoptysis

Question 2

What treatment can be used for the treatment of DVT where anticoagulation is not possible or for recurrent DVT?

Answer 2

IVC referral

Question 3

What is phlegmonia cerulea dolens?

Answer 3

A serious complication of DVT where there is severe swelling, pain and cyanosis which can result in gangrene and need for amputation

Question 4

What are the potential complications of DVT?

Answer 4

PE
Recurrence
Effects of treatment
Phlegmonia cerulea dolens
Post thrombotic syndrome

Question 5

What are the potential complications of PE?

Answer 5

Further embolus e.g. stroke
Recurrence
Pulmonary infarct -> respiratory failure
Cardiac arrest

Question 6

What test can be used as an alternative to CTPA in an unstable patient with suspected PE?

Answer 6

ECHO

Question 7

Where is leg circumference measured from in suspected DVT, and what difference in circumference between legs would be considered significant?

Answer 7

Measured from 10cm below tibial tuberosity

Significant if >3cm difference between legs