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Very low-risk pulmonary embolism exclusion — RCPSC EM MCQ

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ModerateRespiratory emergenciesVery low-risk pulmonary embolism exclusionRCPSC EM

A 28-year-old has sharp chest pain after a viral cough. HR is 74/min, oxygen saturation is 99%, there is no leg swelling, haemoptysis, surgery, estrogen use, or prior VTE. Clinician gestalt for PE is very low and ECG is normal. What is the most appropriate disposition?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Discharge with safety-netting without D-dimer testing

Discharge with safety-netting without D-dimer testing is correct: the clues indicate Very low-risk pulmonary embolism exclusion and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian ED PE risk stratification practice