Please select the eligibility criteria that correspond to the clinical trial below.
Title: Increasing Safe Outpatient Care for Emergency Department Patients With Acute Pulmonary Embolism: a Pragmatic Trial
Brief Summary: To evaluate the impact of an integrated electronic clinical decision support system to facilitate risk stratification and site-of-care decision-making for patients with acute pulmonary embolism.


Options:
A: Inclusion Criteria:

* outpatient with a pulmonary embolism, confirmed by locally approved guidelines
* aged 18 years and above
* written informed consent

Exclusion Criteria:

* hemodynamic or respiratory instability defined as one of the following; hypotension RR systolic\< 90 mmHg,pulse rate\> 100 bpm, need for oxygen therapy to maintain oxygen saturation above 90 %, collapse
* illness unrelated to PE for which the patient would require hospitalization
* pain requiring intravenous narcotics
* thrombolysis
* active bleeding or thrombopathy
* pregnancy
* in hospital patients
* physical or psychiatric inability for home treatment
* no support system at home renal insufficiency
B: Inclusion Criteria:

* Acute objectively-confirmed pulmonary embolism, diagnosed in the emergency department

Exclusion Criteria:

* Comfort-care only
* Left the ED against medical advice
* Current PE radiologically diagnosed \>12 hrs prior to arrival
* Recent DVT or PE diagnosed within 30 days
* Pregnant
C: Inclusion Criteria:

1. Pulmonary Embolism, diagnosed by CTA or high probability VQ Scan
2. Total Pulmonary Embolism Severity Index (PESI) score \<86

Exclusion Criteria:

1. Massive Pulmonary Embolism: Hypotension with signs of right heart strain on CTA or Echocardiogram
2. Sustained Systolic Blood Pressure (SBP) \<95 mmHg during Emergency Department or observation stay.
3. Age \<18
4. Pregnant
5. Renal insufficiency (Creatinine Clearance \<30)
6. Hepatic Dysfunction (AST/ALT/ALP \> 3 times upper limit of normal)
7. Unreliable social situation or inability to follow up
8. Contraindication to enoxaparin, warfarin and rivaroxaban
9. Atrial or ventricular dysrhythmia(s)
D: Inclusion Criteria:

* age \>18 years
* objectively confirmed diagnosis of pulmonary embolism
* patients at low-risk (Pulmonary Embolism Severity Index score \<=85)

Exclusion Criteria:

* patients at high-risk (Pulmonary Embolism Severity Index score \>85)
* presence of hypoxemia (arterial SO2 \<90% measured by pulse oximetry or an paO2 on room air of \<60 mm Hg measured by blood gas analysis)
* systolic blood pressure of \<100 mm Hg
* chest pain necessitating parenteral opioid administration
* active bleeding or at high-risk of major bleeding (stroke during the preceding 10 days, gastrointestinal bleeding during the preceding 14 days, or platelets \<75,000 per mm3)
* renal failure (creatinine clearance of \<30 ml/minute based on the Cockcroft-Gault formula)
* body mass \>150 kg
* history of HIT or allergy to heparins
* therapeutic oral anticoagulation (INR ≥2)at the time of pulmonary embolism diagnosis
* potential barriers to treatment adherence or follow-up (alcoholism, illicit current or recent drug use, psychosis, dementia, homelessness, lack of telephone access, transportation time to nearest ED \>45 minutes)
* known pregnancy
* imprisonment
* diagnosis of pulmonary embolism \>23 hours ago
* refusal or inability to provide informed consent
* prior enrollment in the study

Answer: B