NICE One-Pagers


VTE Management




Pulmonary Embolism


Pharmacological treatment:

Thrombolytic therapy

(Note anti-coagulants stop clot growing, not dispersion)

Mechanical intervention:

Wells Two-Level DVT Score >2 PE Likely (NICE)

Active cancer (treatment ongoing, within 6 months, or palliative) 1.0
Paralysis, paresis or recent plaster immobilisation of the lower extremities 1.0
Recently bedridden for 3 days or more or major surgery within 12 weeks requiring general or regional anaesthesia 1.0
Localised tenderness along the distribution of the deep venous system 1.0
Entire leg swollen 1.0
Calf swelling at least 3 cm larger than asymptomatic side 1.0
Pitting oedema confined to the symptomatic leg 1.0
Collateral superficial veins (non-varicose) 1.0
Previously documented DVT 1.0
An alternative diagnosis is at least as likely as DVT -2.0

Clinical probability simplified score

Wells Two-Level PE Score >4 PE Likely (NICE)

Clinically suspected DVT (minimum leg swelling and pain on palpation of deep veins). 3.0
Alternative diagnosis less likely than PE. 3.0
Tachycardia (heart rate above 100 beats per minute). 1.5
Immobilisation for more than three days or surgery in the previous four weeks. 1.5
History of DVT or PE. 1.5
Haemoptysis. 1.0
Malignancy (on treatment in the preceding six months or palliative stage). 1.0