Assess symptoms: sudden shortness of breath, chest pain, rapid heart rate, coughing up blood, fainting
Check vital signs: oxygen saturation, heart rate, blood pressure, respiratory rate
Review risk factors: recent surgery, immobility, pregnancy, cancer, prior blood clots, estrogen use
Perform physical examination for leg swelling, tenderness, or signs of deep vein thrombosis
Apply clinical prediction rules: Wells score, Geneva score, PERC rule
Order D-dimer test if pretest probability is low or moderate
Obtain CT pulmonary angiography if pulmonary embolism is suspected
Use ventilation-perfusion scan if CT is contraindicated or unavailable
Perform compression ultrasound of the legs if deep vein thrombosis is suspected
Consider ECG, chest X-ray, and blood tests to assess other causes and complications
Seek emergency medical care immediately if symptoms are severe or sudden