PE Triage Calculator — Reperfusion Triage for Pulmonary Embolism

What it does

The calculator takes hemodynamics, RV strain, biomarkers and trajectory inside a defined stability window, then emits an ESC-style risk label — low, intermediate-low, intermediate-high — and one of four recommendation cards with explicit escalation triggers.

The design bias is conservative on purpose. Medical management is the default output unless instability or measured deterioration is present. It was built to cut low-yield IR consults without missing the patient who is genuinely decompensating.

The two gating checks

• Hemodynamic instability — shock physiology or arrest — routes straight to the high-risk pathway, before any risk labeling happens.
• Objective deterioration inside the stability window routes to escalation when intermediate-high features are present.

Inputs it uses

• Setting — ED new diagnosis versus inpatient — with a 4 to 6 hour or 24 hour stability window.
• Hemodynamics: current SBP, lowest SBP, baseline SBP, sustained hypotension, CPR, and pressor requirement tiers.
• Hypoperfusion markers: lactate trend, altered mental status, oliguria, cool or clammy skin.
• RV strain by RV/LV ratio and CT or echo RV dysfunction, plus troponin and BNP / NT-proBNP categories.
• Modifiers: symptom duration, clot location, thrombolysis contraindication, current oxygen support.

Output logic

• Medical management — anticoagulation plus close monitoring. This is the default.
• Watchlist — pulmonary or PERT discussion, with IR optional for planning.
• Deteriorating intermediate-high — reperfusion considered, PERT plus IR.
• High-risk massive — emergency reperfusion pathway.

Why it is built this way

Intermediate-high risk is not automatically a procedure indication. Trajectory matters, and consult volume is driven by uncertainty rather than by deterioration. Defining deterioration objectively — oxygen escalation, SBP trend, tachycardia, rising lactate, ICU upgrade — rather than by clinician gestalt is what reduces inter-team churn, because both teams are then arguing about the same thing.

Technically it is a single HTML file with embedded CSS and JS, no external dependencies, no tracking and no backend calls. The copy-summary function is for de-identified summaries only. Do not enter patient identifiers.

For educational reference only. Clinical decisions require the physician's judgment of the individual patient. This tool supports that judgment; it does not replace it.

Written and reviewed by Pouyan Golshani, MD — February 2026