PERC Rule
Rules out PE when all criteria absent AND pre-test probability <=15%
- Highest activation tier
- Recommended
- How it is scored
- Interactive form only; never scored passively
- Care settings
- Emergency department
Calculate
Answer every item. The result uses the same scoring code Scribeable runs in notes. Nothing you enter leaves this page.
Age 50 or older
Heart rate 100 beats/min or higher
SpO2 below 95% on room air
Unilateral leg swelling
Hemoptysis
Surgery or trauma within 4 weeks
Prior DVT or PE
Hormone (estrogen) use
Enter the values above to see the result.
When it activates
Scribeable activates a calculator from the encounter. The PERC Rule can activate when the transcript or pasted chart context documents any of these:
- Low suspicion PE evaluation
- Avoiding unnecessary D-dimer
- Low-risk chest pain/dyspnea
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: I26.
For the PERC Rule, activation has no note-facing effect: form-only calculators are filtered out of every tier of the drafting guidance, so the draft is neither steered to it nor scored on it. Activation only lists it among the calculators the cockpit offers as an interactive form.
Note-type scope: it activates on notes whose subject resolves to emergency medicine, pulmonology, hospital medicine, cardiology. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
8 inputs. These are the interactive form's inputs; none is read from the transcript or chart, and no score is inserted into the note.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Age >=50 | age | ||
| HR >=100 | vital | bpm | |
| SpO2 <95% | vital | % | |
| Unilateral leg swelling | exam | Swelling of one leg only (PERC criterion). | |
| Hemoptysis | symptom | Coughing up blood (PERC criterion). | |
| Surgery/trauma <=4 weeks | history | Surgery or trauma within the past 4 weeks (PERC criterion). | |
| Prior PE or DVT | history | Previously diagnosed PE or DVT (PERC criterion). | |
| OCP or HRT use | medication | Oral contraceptives, HRT, or other exogenous estrogen (PERC criterion). |
Scoring
All 8 criteria must be ABSENT to rule out PE. Any positive = cannot rule out.
PERC-negative requires ALL absent: Age≥50 Age >=50, HR≥100 HR >=100, SpO2<95% SpO2 <95%, leg swelling Unilateral leg swelling, hemoptysis Hemoptysis, recent surgery/trauma Surgery/trauma <=4 weeks, prior VTE Prior PE or DVT, hormones OCP or HRT use
Interpretation
ONLY apply if pre-test probability is low (<=15%). All 8 criteria absent = PE ruled out. Any positive = proceed with D-dimer.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Kline JA et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected PEKline et al. (PERC) 2004 · 2004 · Level I · link last verified 2026-03-23
How Scribeable handles it in the note
Scribeable never scores the PERC Rule from a transcript or pasted chart on its own: no computed value is inserted into the draft, surfaced beside it, or checked against a stated one.
It is available as a deliberate interactive form in the web cockpit. You confirm every input yourself, and the result is added to the note only after you review it, because applying this tool is a clinician judgement the chart cannot supply.
Classified as a mandatory rule-out score: a missed result carries acute harm, so the activation filter never approves it on uncertainty.
Score it deliberately on your own encounter
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