Altitude-adjusted PERC (Madsen 2019). Same eight Kline factors as sea-level PERC except hypoxia is O2 sat <90% at ~4980 ft, not <95%. PERC-negative only when all eight hold: age <50, pulse <100, SaO2 ≥90%, and no unilateral leg swelling, hemoptysis, recent trauma or surgery, prior PE or DVT, or hormone use. Caller must already have low pretest probability as in Kline. Not a PE diagnosis, not sea-level PERC, and not a medical device.

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