Author’s Conclusions:

“Clinicians should not use the observation of normalized vital signs as a reason to forego objective testing for symptomatic patients with a risk factor for PE.”

Our Conclusions:

If you have a patient in whom you suspect PE, the normalization of their vital signs during their time in the ED should not reassure you that they do not have a PE.

Potential Impact To Current Practice:

This study suggests that when formulating clinical gestalt or when applying vital signs to a clinical decision making rule, the most abnormal vital sign should be used.

Clinical Bottom Line:

For patients in whom you suspect PE, normalization of vital signs should not be used as a rationale to lower your pretest probability for the disease. The best approach is to use the most abnormal vital sign measurement when determining the pre-test probability of a PE in the patient.

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