ACUTE PULMONARY EMBOLISM: PROBLEMS OF DIAGNOSIS IN PREHOSPITAL SETTING
OBJECTIVES The article deals questions related to the diagnosis and differential diagnosis of acute pulmonary embolism in pre-hospital setting. MATERIAL AND METHODS Medical documentation 83 patients with verifi ed pulmonary embolism, 102 patients with suspected pulmonary embolism and 76 patients with suspected acute coronary syndrome. We have analyzed clinical and ECG features of illness and retrospectively evaluated the probability of pulmonary embolism with Revised Geneva Score. RESULTS In the overall structure of ambulance calls about 0.06% accounts for the pulmonary embolism. PE overdiagnosed or missed cases are 40% and 27% respectively. In 92% of patients with verifi ed PE was defi ned high or medium estimated probability of its existence, in 8% - low. 48% of patients with suspected acute coronary syndrome had high or medium risk of PE. CONCLUSION PE is rarely diagnosed pathological condition in the pre-hospital stage. Diagnostic diffi culties in the acute period are due to non-specifi city of disease clinical and ECG signs.