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Dizziness, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Patients’ descriptions of symptom quality (vertigo, lightheadedness, disequilibrium, or “other”) are frequently misleading and should not be the basis of clinical decision making.

  • An ...

Diagnosis

Signs and Symptoms

History

Define the timing and triggers category and determine if the ROS suggests a particular serious diagnosis: 
  • Is the dizziness abrupt or gradual in onset?

  • Is the dizzines...

Treatment

Initial Stabilization/Therapy

  • Abnormal vital signs clinically managed

  • Stabilization should be determined by more specific classification of dizziness based on the history, physical exam, and a...

Follow-Up

Disposition

Admission Criteria

Admission or discharge of patients with dizziness should be based on the underlying etiology or associated symptoms. 

Discharge Criteria

  • Admission or discharge of ...

Pearls and Pitfalls

  • Use the “timing and triggers” technique to diagnose dizzy patients.

  • Advanced age and traditional stroke risk factors increase the likelihood of acute stroke as cause of dizziness.

  • No...

Additional Reading

  • Edlow  JA, Newman-Toker  DE, Savitz  SI. Diagnosis and initial management of cerebellar infarction. Lancet Neurol.  2008;7:951–964.

  • Hwang  DY, Silva  GS, Furie  KL, et al. Compa...

Codes

ICD9

  • 386.11 Benign paroxysmal positional vertigo

  • 386.30 Labyrinthitis, unspecified

  • 780.4 Dizziness and giddiness

  • 386.12 Vestibular neuronitis

ICD10

  • H81.10 Benign paroxysmal vertigo, unspecified ear

  • H83...

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