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The Geneva score is a clinical prediction rule used in determining the pre-test probability of pulmonary embolism (PE) based on a patient's risk factors and clinical findings. [1] It has been shown to be as accurate as the Wells Score, and is less reliant on the experience of the doctor applying the rule. [2]
The Wells score is a clinical prediction rule used to classify patients suspected of having pulmonary embolism (PE) into risk groups by quantifying the pre-test probability. It is different than Wells score for DVT (deep vein thrombosis).
The pulmonary embolism rule-out criteria (PERC) helps assess people in whom pulmonary embolism is suspected, but unlikely. Unlike the Wells score and Geneva score , which are clinical prediction rules intended to risk stratify people with suspected PE, the PERC rule is designed to rule out the risk of PE in people when the physician has already ...
It is regarded as a highly sensitive and specific test for pulmonary embolism. [1] CTPA is typically only requested if pulmonary embolism is suspected clinically. If the probability of PE is considered low, a blood test called D-dimer may be requested. If this is negative and risk of a PE is considered negligible, then CTPA or other scans are ...
In a prediction rule study, investigators identify a consecutive group of patients who are suspected of having a specific disease or outcome. The investigators then obtain a standard set of clinical observations on each patient and a test or clinical follow-up to define the true state of the patient.
Tracheal deviation may also be present, shifted away from the affected side. Thus, a lung exam is important. Other findings may include decreased chest mobility and air underneath the skin (subcutaneous emphysema). [12] Pulmonary embolism similarly presents with shortness of breath and hypoxia. Chest pain worse with inspiration is frequently seen.
A defect in the perfusion images requires a mismatched ventilation defect to indicate pulmonary embolism. [8] In the ventilation phase of the test, a gaseous radionuclides such as xenon-133, krypton-81m, or technetium-99m DTPA in an aerosol form is inhaled by the patient through a mouthpiece or mask that covers the nose and mouth. [10]
After positioning in which the patient sits upright with their arms at the side, with the chest clear of clothing, the four stages of the examination can be carried out. In order to listen to the lungs from the back the patient is asked to move their arms forward to prevent the scapulae (shoulder blades) from obstructing the upper lung fields.