PE workup · Clinical score
The Wells score is a seven-criterion bedside tool for estimating pre-test probability of pulmonary embolism. It is widely taught in emergency medicine because it folds history, exam, and gestalt into a single number that maps onto three published probability bands. The band breakdown below mirrors the published stratification, and the tool beneath it applies the score live as you tick the criteria.
In the emergency department, the Wells score complements clinical gestalt and objective findings (heart rate, signs of DVT, hemoptysis, recent immobilization or surgery, prior venous thromboembolism, and active malignancy). The seven items sum to a total that places the patient in one of three probability bands — low, moderate, or high — and that band shapes the next step in the workup: a PERC rule-out, a D-dimer, or a direct move to imaging with empirical anticoagulation where appropriate.
The score guides the path through the workup but never replaces it. Always follow the local PE protocol; high-sensitivity D-dimer has its own caveats in pregnancy, post-op patients, and the elderly, and imaging decisions depend on renal function, contrast allergy, and radiation considerations that the indexed calculator does not weigh for you.
Population-level pre-test probability by Wells total. Use the band as the next-step signal in your workup; it is informational, not a recommendation.
Low
PE is unlikely on this presentation. PERC is a sensible next step; if PERC is negative, the workup can stop here without imaging.
Moderate
Symptomatic PE remains plausible. The next decision is imaging — D-dimer may still rule out in low-likelihood patients; CTPA is the usual default.
High
Pre-test probability is high enough that imaging is the next move, not a D-dimer. Initiate anticoagulation per local protocol pending the result.
Open the calculator
Pick the seven Wells criteria. Total, risk tier, and pre-test probability update live as you tick each box. When you are done, copy or print a clean clinical summary for the chart.
Informational only. Not a substitute for clinical judgement. Not a patient record — Wells scores are not persisted; a refresh clears the result. Population-level estimates; always follow your institution’s PE protocol and risk-stratify with imaging and clinical gestalt.