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Increased ordering of imaging studies has led to a rise in both healthcare costs and length of hospitalization. Up to 50% of imaging may be "medically unnecessary". One of the most common clinical scenarios which has seen a sharp rise in the ordering of CT scan imaging is evaluation of pulmonary embolism. Pulmonary embolism is a challenging diagnosis due to the non-specific nature of symptoms and its vast differential diagnosis. Multiple evidence-based algorithms have been developed to aid in diagnostic precision, algorithms which have not been properly executed by healthcare staff. This failure to follow guidelines has resulted in ordering of unnecessary testing in the ED. The purpose of this investigation is to determine how many of the studies ordered followed established indications and appropriateness of CTA imaging in emergency department patients.