PE-Path | Acute Pulmonary Embolism Classification and Management Pathway

Guided assessment

Enter the available clinical findings

Categories are assigned using the highest-severity applicable feature. Reassess if the patient's condition changes.

1Presentation 2Patient information 3RV + biomarkers 4Status

01Clinical presentation

PresentationPatient's clinical presentation

AnatomyMost proximal clot location

Symptoms may include: dyspnea, pleuritic chest pain, hemoptysis, syncope/presyncope, or exercise intolerance.

02Patient information

These findings contribute to the PESI, sPESI, and Bova risk summaries shown with the classification results. Elevated clinical severity is present when PESI is >85, sPESI is ≥1, or Bova is >4.

AgeyearsSexHeart rate/minSystolic BPmmHgRespiratory rate/minTemperature°CSpO₂%

Active malignancyHistory of heart failureHistory of chronic lung diseaseAltered mental status

History of hypertension treated with antihypertensive medication

AIncidentalBSymptomaticCRV injuryDFailureECollapse

Classification

Symptomatic, low severity — non-subsegmental

The patient is symptomatic with no elevated clinical-severity threshold (PESI 60 (Class I), sPESI 0, and Bova 0) and segmental PE.

Respiratory modifierNot applicable

Guideline Recommendations

Disposition & care setting

Outpatient or early discharge Use Hestia or another structured low-risk pathway. If outpatient criteria are not met but the patient remains clinically stable, a medical-surgical floor is generally appropriate unless another condition requires higher-acuity care.

Anticoagulation choice

Use a DOAC first line when eligible. Apixaban 10 mg twice daily for 7 days or rivaroxaban 15 mg twice daily with food for 21 days, followed by the maintenance regimen. Category A still requires clinician review of whether treatment or structured surveillance is appropriate.

Systemic thrombolysis

Do not use for Categories A–C2. For these categories, systemic thrombolysis should not be used over anticoagulation alone because it increases major bleeding and intracranial hemorrhage (Class 3: Harm).

PERT team activation

Not routinely required for low-risk categories. Seek multidisciplinary input when the diagnosis, outpatient candidacy, bleeding risk, or treatment plan remains uncertain.

Lab & monitoring protocol

Reassess clinically before discharge. Repeat vital signs and review oxygenation, symptoms, ambulation, bleeding risk, and access to therapy; routine inpatient biomarker monitoring is generally unnecessary when low-risk status is confirmed.

Open detailed management pathway

Clinical safeguards

Verify all inputs, contraindications, bleeding risk, renal and hepatic function, pregnancy, medication interactions, and local protocols. Reassess whenever clinical status changes; this prototype does not provide treatment orders.

Acute Pulmonary Embolism Classification and Management Pathway

Enter the available clinical findings

Right-heart strain

Cardiac and perfusion biomarkers