dizziness

Beyond Vestibular

People need support when they are in crisis and are often dismissed as having a mental health issue with a psych consult in the ED due to poor coping skills. It has been reported by many patient advocacy organizations that people with complex and chronic health conditions such as the ones discussed see > 5-7 MDs before acquiring a diagnosis. Specialty provider appointments often have month-long waiting lists and PTs can be instrumental in partnering with patients to identify symptom triggers and to address specific impairments to help turn down the volume of ANS and immune reactivity until medical help can be acquired. PTs are primary care providers and need innovative tools like DizzyDx™ to help with clinical reasoning.

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You’re the Dizziness Detective in the ED

A 52 year old patient sits very still in a chair at your facility’s Emergency Department, with her eyes closed and an emesis pan in arm’s reach. One glance at the chart tells you what you’ve already guessed – the patient came in with complaints of acute vertigo, the nurse recently gave her Zofran to manage nausea, and an MRI of her head has come back negative for stroke. Of course, you know that an MRI can be falsely negative for stroke in at least 12% of patients in the first 24-48 hours from symptom onset (Kattah et al., 2009). As the physical therapist assigned to the ED and renowned “dizziness detective,” you’ve been asked to help out. What do you do first?

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