PERC Rule Calculator

Apply the eight Pulmonary Embolism Rule-out Criteria in adults with a clinician-assessed low pretest probability of pulmonary embolism. Calculate and interpret the result with clinical guidance, limitations and references.

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PERC Rule
Clinical Decision Tool

Apply the eight Pulmonary Embolism Rule-out Criteria in adults with a clinician-assessed low pretest probability of pulmonary embolism.

PERC should only be used after a clinician has judged pulmonary embolism to be low probability.
Select Yes when the patient is aged 50 years or older.
Select Yes when the measured heart rate is at least 100 beats per minute.
Select Yes when room-air oxygen saturation is below 95%.
Select Yes when unilateral leg swelling is present.
Select Yes when the patient has haemoptysis.
Select Yes for surgery or trauma requiring hospitalisation within the previous four weeks.
Select Yes for any previous deep-vein thrombosis or pulmonary embolism.
Select Yes when the patient is currently using exogenous oestrogen.
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Clinical Decision Support Only

MediCalc calculators are intended to support qualified healthcare professionals and must not replace professional clinical judgement. Do not enter patient-identifiable information into Saved Progress.

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MedicalC Knowledge Hub

PERC Rule: Clinical Guide

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Apply the eight Pulmonary Embolism Rule-out Criteria in adults with a clinician-assessed low pretest probability of pulmonary embolism. This clinical guide explains the inputs, method, interpretation, limitations and evidence supporting the tool.

Overview

PERC Rule is a Emergency Medicine tool that uses Yes — pulmonary embolism has been assessed as low probability to produce a structured clinical result. Use it for the clinical purpose described by the calculator and only in an appropriate patient population.

Clinical Significance

The result supports consistent assessment, calculation and communication. It should be combined with the full history, examination, investigations, trajectory of illness and local clinical guidance.

When to Use

  • Use when the clinical question matches the stated purpose of PERC Rule.
  • Confirm that the patient falls within the population for which the method is intended.
  • Use current and accurately measured inputs, with the correct units and definitions.

How It Is Calculated

  • The calculator applies the established PERC Rule method to Yes — pulmonary embolism has been assessed as low probability.

Interpretation

  • Interpret the reported value or category using the explanation displayed with the result.
  • Escalate assessment when the clinical picture is more concerning than the calculated category.

Worked Example

Enter a clinically consistent example set of Yes — pulmonary embolism has been assessed as low probability. The calculator then applies the established PERC Rule logic and displays the resulting value or category with its interpretation.

Patient Considerations

  • Consider age, comorbidity, pregnancy, organ dysfunction, treatment already given and whether the patient differs from the original validation population.
  • Review trends and clinical deterioration rather than relying only on a single calculation.

Limitations

  • The tool may perform differently outside its derivation and validation settings.
  • Missing, estimated, delayed or incorrectly converted inputs can materially alter the result.
  • The calculation cannot account for every diagnosis, contraindication or urgent clinical feature.

Clinical Pearls

  • Check each input against the calculator definition before submission.
  • Document the component values as well as the final score or calculated result.
  • Repeat the calculation when relevant observations, laboratory results or treatment change.

Common Mistakes

  • Using the tool for an ineligible patient or a different clinical purpose.
  • Entering values in the wrong units or selecting a category from incomplete information.
  • Allowing a reassuring result to override significant symptoms, examination findings or clinical deterioration.

Evidence Base

PERC Rule is based on the established equation, criteria or scoring system implemented in the calculator. Clinical performance depends on the original evidence base, subsequent validation studies and correct application to the intended population.

Frequently Asked Questions

What is PERC Rule used for?

Apply the eight Pulmonary Embolism Rule-out Criteria in adults with a clinician-assessed low pretest probability of pulmonary embolism.

Which inputs are required?

The calculator uses Yes — pulmonary embolism has been assessed as low probability. Check the displayed units and category definitions before entry.

Can the result be used on its own?

No. It supports but does not replace clinical assessment, investigation, local pathways or specialist advice.

When should the calculation be repeated?

Repeat it when a relevant clinical observation, laboratory value, treatment or the patient’s condition changes.

References

  1. Apply the eight Pulmonary Embolism Rule-out Criteria in adults with a clinician-assessed low pretest probability of pulmonary embolism. — Primary publication or authoritative guidance supporting this calculator.
  2. All eight PERC criteria are negative. In an adult with a clinician-assessed low pretest probability of pulmonary embolism, PERC supports stopping further PE testing, subject to clinical judgement and the applicable local pathway. — Primary publication or authoritative guidance supporting this calculator.
  3. Kline JA et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. 2004;2(8):1247–1255. — Primary publication or authoritative guidance supporting this calculator.
  4. Kline JA et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6(5):772–780. — Primary publication or authoritative guidance supporting this calculator.

Reviewed by: MedicalC Clinical Editorial Team
Last reviewed: July 2026

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Reviewed by: MedicalC Clinical Editorial Team Last reviewed: July 2026

Clinical Disclaimer

MedicalC calculators and clinical tools are intended to support healthcare professionals. They do not replace clinical judgement, individual patient assessment, local guidance or specialist advice.

Results should always be interpreted in the context of the patient’s history, examination, investigations, current clinical condition and applicable professional guidance.

Reviewed by: MedicalC Clinical Editorial Team Last reviewed: July 2026
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