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Abstract Details

In-house Diagnosis and Management of Peripheral Vertigo Patients, Where Do We Stand? An Adult Neurology Quality Improvement Study
General Neurology
P4 - Poster Session 4 (11:45 AM-12:45 PM)
Peripheral vertigo accounts for 60% of vertigo cases presenting to emergency departments (ED). Its management, consequently, requires a collaborative approach between a multidisciplinary team that includes clinicians, nurses, physical (vestibular) therapists, and pharmacists. The care for such a condition requires an appropriate diagnosis and combined medical and rehabilitation treatments. Inadequate diagnosis, management, and proper referral to vestibular rehab might lead to unnecessary recurrent ED visits. This study aims to identify the level of care provided for patients with peripheral vertigo presenting to the ED of an academic medical center.

To identify if peripheral vertigo patients receive the standard in-hospital care.

A retrospective chart review study of patients with peripheral vertigo presented to the ED of an academic medical center from January to December 2022.

Our Neurology service was consulted on forty-nine patients with peripheral vertigo who presented to the ED in 2022. DHT was performed in 29 (53%). Symptomatic medical treatment was provided to 45 patients (91.8%); one patient received Intravenous fluids (IVF) only, five received Meclizine only, ten received a combination of 2 treatments (e.g., IVF + Meclizine), twelve received a variety of 3 treatments including antiemetics (e.g., IVF + Meclizine/Zofran+ valium), and 17 received at least 4 treatments. 27 patients (55.1%) were admitted to inpatient vs. 19 (38.7%) discharged from the ED at 0 day. Only 9/49 (18.3%) were referred to vestibular rehab upon discharge; of those, only 6.1% followed up. Seven patients (14.2%) presented a few days later with recurrent symptoms.

Our study highlights the deficiencies in the care provided to peripheral vertigo patients presenting to the ED and the importance of outpatient referral. This can prevent inappropriate repeated utilization of ED services. Suggested interventions include creating standardized management protocols including different maneuvers, vertigo cards with explanatory flow charts and ensuring proper referral to vestibular rehab.

Lobna A. Abdelwahab, MD (SUNY Downstate Medical Center)
Dr. Abdelwahab has nothing to disclose.
Jaahnavee Trivedi, MD (SUNY downstate Health Science University) Dr. Trivedi has nothing to disclose.
Aditya Chanpura Mr. Chanpura has nothing to disclose.
Yaacov Anziska, MD (SUNY-Downstate Medical Center) Dr. Anziska has nothing to disclose.