Wells’ score for early prehospital screening of pulmonary embolism
1Municipal EMS Institute, Belgrade, Serbia
DOI: 10.22514/SV121.102016.25 Vol.12,Issue S1,October 2016 pp.131-133
Published: 10 October 2016
Pulmonary embolism (PE) represents a significant health problem due to non-specific clinical features and a high risk of lethal outcome. PE diagnostics can some-times be very difficult, especially at the prehospital level. We present a patient in whom early screening for PE at the pre-hospital level, performed using the Wells’ Score, was a life-saving event.
Case scenario: the Emergency Medical Service (EMS) received a call regarding a male, aged 27 years, who was unconscious. Prior to losing consciousness, he com-plained of suffocation and tachycardia. Ten days earlier he sustained an injury to the knee which was immobilized with a splint, followed by bed rest. A year ago he was examined for chest pain, hypertension and tachycardia. On examination the pa-tient was conscious, well oriented, eupneic, afebrile, with normal skin color. On pul-monary auscultation breath sounds were normal, and oxygen saturation was 90%. Findings on cardiac examination includ-ed: regular rate and rhythm, no murmur, blood pressure (BP) 120/85mmHg on both arms. ECG revealed sinus rhythm, rate of 100 beats/min, discreet signs of right heart strain (S1Q3T3 pattern), negative T wave from V1-V4, ST depression in D2, D3, AVF. A Wells’ score of 6 (most probably PE) was calculated: immobilization for 4 weeks – 1.5 points, tachycardia (pulse 120/min) – 1.5 points and alternative diagnosis less probable than PE – 3 points. The pa-tient was suspected of PE and referred to a cardiologist.
Conclusion. Pulmonary embolism often remains undiagnosed during a patient’s lifetime or is erroneously diagnosed. The significance of the scoring of each patient aimed at the recognition of pulmonary embolism at the prehospital level cannot be underestimated.
pulmonary embolism, prehospi-tal level, Wells’ Score
VLADA TAMBURKOVSKI,SLAĐANA ANĐELIĆ. Wells’ score for early prehospital screening of pulmonary embolism. Signa Vitae. 2016. 12(S1);131-133.
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