| Emergency Medicine Clinical Calculators
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| Interactive scoring tools for clinical decision-making at the bedside. Select responses below and scores will calculate automatically.
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1. HEART Score for Major Cardiac Events
Predicts 6-week risk of major adverse cardiac events (MACE) in patients presenting with chest pain.
Use in: Patients ≥21 years old with symptoms suggestive of ACS. Do not use if: New ST-elevation ≥1 mm, hypotension, life expectancy <1 year, or noncardiac illness requiring admission.
HEART Score Calculator
| Criteria
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Select One
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| History
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Slightly suspicious (0)
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Moderately suspicious (+1)
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Highly suspicious (+2)
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| EKG
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Normal (0)
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Non-specific repolarization disturbance (+1)
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Significant ST deviation (+2)
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| Age
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<45 (0)
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45–64 (+1)
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≥65 (+2)
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| Risk Factors
HTN, hypercholesterolemia, DM, obesity (BMI >30), smoking, family hx CVD, or hx atherosclerotic disease
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No known risk factors (0)
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1–2 risk factors (+1)
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≥3 risk factors or hx atherosclerotic disease (+2)
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| Initial Troponin
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≤normal limit (0)
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1–3× normal limit (+1)
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>3× normal limit (+2)
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| HEART Score
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/ 10
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Interpretation
| 0–3
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Low Risk — 0.9–1.7% risk of MACE. Consider discharge with outpatient follow-up.
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| 4–6
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Moderate Risk — 12–16.6% risk of MACE. Consider admission for observation and further workup.
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| 7–10
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High Risk — 50–65% risk of MACE. Consider early invasive measures (cardiology consult, catheterization).
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2. Wells' Criteria for Pulmonary Embolism
Objectifies risk of pulmonary embolism based on clinical criteria.
Use in: Patients with clinical suspicion for PE. Note: Use clinical judgment first; the Wells score helps quantify pre-test probability.
Wells' PE Score Calculator
| Criteria
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No
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Yes
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Points
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| Clinical signs and symptoms of DVT (leg swelling, pain with palpation)
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1
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+3.0
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| PE is #1 diagnosis OR equally likely
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1
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+3.0
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| Heart rate >100 bpm
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1
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+1.5
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| Immobilization (≥3 days) OR surgery in previous 4 weeks
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1
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+1.5
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| Previous objectively diagnosed PE or DVT
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1
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+1.5
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| Hemoptysis
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1
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+1.0
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| Malignancy (treatment within 6 months or palliative)
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1
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+1.0
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| Wells' Score
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points
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Three-Tier Model
| 0–1
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Low Risk — 1.3% incidence of PE. Consider D-dimer to rule out. Consider PERC rule.
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| 2–6
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Moderate Risk — 16.2% incidence of PE. Consider high-sensitivity D-dimer or CTA.
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| >6
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High Risk — 37.5% incidence of PE. Consider CTA. D-dimer not recommended.
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Two-Tier Model (Preferred by guidelines)
| 0–4
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PE Unlikely — 12.1% incidence. Consider high-sensitivity D-dimer; if negative, stop workup.
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| >4
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PE Likely — 37.1% incidence. Consider CTA testing.
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3. CURB-65 Score for Pneumonia Severity
Estimates 30-day mortality of community-acquired pneumonia (CAP) to help determine inpatient vs. outpatient treatment.
Use in: Adult patients with confirmed or suspected community-acquired pneumonia.
CURB-65 Calculator
| Criteria
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No (0)
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Yes (+1)
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| Confusion (new disorientation in person, place, or time)
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1
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| Uremia — BUN >19 mg/dL (>7 mmol/L)
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1
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| Respiratory rate ≥30 breaths/min
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1
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| Blood pressure — SBP <90 mmHg or DBP ≤60 mmHg
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1
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| Age ≥65 years
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1
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| CURB-65 Score
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/ 5
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Interpretation & Disposition
| 0–1
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Low Risk — 1.5% 30-day mortality. Consider outpatient treatment with oral antibiotics.
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| 2
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Moderate Risk — 9.2% 30-day mortality. Consider short inpatient stay or closely monitored observation.
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| 3–5
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High Risk — 22% 30-day mortality. Inpatient admission recommended. ICU if score 4–5.
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4. Glasgow Coma Scale (GCS)
Assesses level of consciousness based on Eye, Verbal, and Motor responses. Score range: 3–15.
Use in: Any patient requiring neurological assessment — trauma, stroke, altered mental status. Note: GCS should not be used alone for clinical management decisions.
Glasgow Coma Scale Calculator
| Component
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Response
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Points
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| Eye Opening (E)
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Spontaneous |
+4
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| To verbal command |
+3
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| To pain |
+2
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| No eye opening |
+1
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| Verbal Response (V)
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Oriented |
+5
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| Confused |
+4
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| Inappropriate words |
+3
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| Incomprehensible sounds |
+2
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| No verbal response |
+1
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| Motor Response (M)
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Obeys commands |
+6
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| Localizes pain |
+5
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| Withdrawal from pain |
+4
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| Flexion to pain (decorticate) |
+3
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| Extension to pain (decerebrate) |
+2
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| No motor response |
+1
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| GCS Score
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/ 15
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Interpretation
| 13–15
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Mild brain injury
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| 9–12
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Moderate brain injury
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| 3–8
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Severe brain injury — consider intubation if unable to protect airway
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5. PERC Rule for Pulmonary Embolism
Rules out PE if NO criteria are present and pre-test probability is ≤15% (low risk by gestalt).
Use in: Low-risk patients where PE has been considered but is not the leading diagnosis. Key point: ALL criteria must be negative (No) to rule out PE. If ANY are positive, PERC cannot rule out PE.
PERC Rule Calculator
| Criteria
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No (0)
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Yes (+1)
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| Age ≥50 years
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1
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| Heart rate ≥100 bpm
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1
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| SpO₂ <95% on room air
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1
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| Unilateral leg swelling
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1
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| Hemoptysis
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1
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| Recent surgery or trauma (within 4 weeks requiring hospitalization)
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1
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| Prior PE or DVT
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1
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| Hormone use (oral contraceptives, HRT, or estrogenic hormones)
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1
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| Positive Criteria
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/ 8
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Interpretation
| Score = 0
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PERC Negative — If pre-test probability is ≤15%, PE is effectively ruled out. No further workup needed (sensitivity 97.4%, negative predictive value 99.5%).
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| Score ≥ 1
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PERC Positive — Cannot rule out PE by PERC alone. Consider D-dimer, Wells' score, or CTA based on clinical suspicion.
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| Disclaimer: These calculators are provided as clinical decision support tools only. They do not replace clinical judgment. Always consider the full clinical picture when making treatment decisions. Scoring systems referenced from peer-reviewed literature. See individual calculator pages for complete references.
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