Discharging low risk PE patients from the ED on rivaroxaban resulted in overall shorter hospital length of stay and lower costs without any increase in serious adverse events.
If clinical gestalt for PE is low, use PERC to rule out PE. If not ruled out, use a validated tool to determine pretest probability of PE: Wells, Revised Geneva, or simplified versions of either score. If non-high or "unlikely" pretest probability, order D-dimer, adjusting for age (<500 or <age x 10). If D-dimer is negative, PE is ruled out. If positive, order CT pulmonary angiogram.