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Old 12-04-2011
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Lungs Pulmonary Embolism; Best next step

If we are presented with a case of Pulmonary embolism and asked next step in Management-

What should we go for V/Q scan Or Spiral CT if both are mentioned in options and pt does not have any previous Pulmonary Disease?

V/Q scan is not reliable in case a pt has a prior pulmonary disease such as COPD but if pt does not have any such problem then what should we answer?
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Old 12-04-2011
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next step of management in PE is always heparin .
If you dont have heparin in options then go for Spiral CT scan
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Quote:
Originally Posted by usmlekzz View Post
next step of management in PE is always heparin .
If you dont have heparin in options then go for Spiral CT scan
I got your point. Heparin 1st.

By this do you mean to say Spiral CT is Better than V/Q or Just the first initial step in Investigations??
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Originally Posted by Adamentium View Post
I got your point. Heparin 1st.

By this do you mean to say Spiral CT is Better than V/Q or Just the first initial step in Investigations??
Uptodate 19.3
updated: October 13, 2011

- For institutions that are experienced at performing and interpreting CT-PA, we encourage an approach which combines clinical probability assessment, D-dimer testing, and CT-PA.
- For institutions that are inexperienced at performing and interpreting CT-PA, or for patients who cannot undergo CT-PA, we encourage an approach which combines clinical probability assessment and ventilation-perfusion (V/Q) scanning.
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