1 See Appendix A: Classifications of Pulmonary Embolism 2 PERT First Responder: On-call fellow/trainee and attending providers 3 See Appendix C: Criteria for After Hours STAT 2D-ECHO 4 Refer to GCC home page (for internal use only) 5 See Appendix D: Contraindications to Anticoagulation Therapy 6 Refer to Adult Heparin Infusion order set 7 If patient has a history of HIT, see Heparin Induced血小板减少治疗(HIT)管理算法8参见附录F:全身性溶栓的禁忌症9●如果患者输注患者,请输注肝素,并在2小时内施加Alteplase 100 mg IV输注。在Alteplase输注完成后立即检查APTT,如果APTT为≤80秒,则在没有推注的情况下重新启动肝素输注。如果APTT> 80秒,请继续持有肝素输注,并每2小时检查APTT,直到APTT≤80秒。●如果患者在LMWH上停止LMWH,并在2小时内施用Alteplase 100 mg IV输注。在下一次预定剂量的LMWH剂量时启动肝素输注而无需推注。●如果患者使用直接作用的口服抗凝剂(DOAC),则停止DOAC并在2小时内施用100 mg IV IV输注的Alteplase。在下一次预定剂量的DOAC剂量时启动肝素输注而无需大推注。