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Medicine (MD/DO)
Internal Medicine
Guidelines, Criteria & Classifications
Wells' Criteria for Pulmonary Embolism

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Wells' Criteria for Pulmonary Embolism

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Wells' Criteria for Pulmonary Embolism

The Well of Pulmonary Embolism
The Wells' Criteria for pulmonary embolism are used to to calculate the probability of a pulmonary embolism in a patient. The criteria include: clinical signs of DVT, PE is the most likely diagnosis, tachycardia, immobility for greater than 3 days, previous history of DVT or PE, hemoptysis and malignancy. Each criteria is associated with a point score. The total score correlates with a probability of having a pulmonary embolism. A score greater than 6 indicates a high probability, 2-6 is a moderate probability, while less than 2 is associated with a low probability.
Clinical Symptoms of DVT (+3)
Symptoms of Deep V Tee (red and swollen calf)

3 points are counted in patients with clinical signs and symptoms of DVT. These include swelling of the leg or along a vein in the leg, pain or tenderness in the leg, increased warmth in the area of the leg that's swollen or painful, or red or discolored skin on the leg.

Pulmonary Embolism Most Likely Diagnosis (+3)
Obvious Pulmonary Embolism

If the alternative diagnosis is less likely than PE, 3 points are added to the score.

Tachycardia (+1.5)

If the patient has tachycardia (Heart rate > 100), 1.5 points are added to the score.

Immobilization > 3 Days (+1.5)
Immobilized Greater-than 3 days

If the patient has a history of immobilization for greater than 3 days, or recent surgery in previous 4 weeks, 1.5 points are added to their score.

Previous DVT or PE (+1.5)
Old DVT and Pulmonary Embolism

If they have a previous history of DVT or PE, 1.5 points are added to their score.

Hemoptysis (+1)
Red-mop coughing blood

If the patient displays hemoptysis, the score gains 1 point.

Malignancy (+1)

If the patient has untreated cancer, one undergoing treatment currently, or in last 6 months, or if they are receiving palliative care, the score increases by 1 point.

> 6 = High
Greater-than 6 is High

A score of greater than 6 correlates with a high probability of pulmonary embolism.

2-6 = Moderate
2 to 6 is Moderate

A score of 2-6 correlates with a moderate probability of pulmonary embolism.

< 2 = Low
Less-than 2 is Low

A score of less than 2 indicates a low probability of diagnosing a pulmonary embolism.


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