Acute Vertigo in the Emergency Department

• Research type

  Research Study

• Full title

  Diagnosis and management of acute vertigo in the emergency department.

• IRAS ID

  233861

• Contact name

  Diego Kaski

• Sponsor organisation

  University College London Hospitals NHS Trust

• Duration of Study in the UK

  2 years, 0 months, 1 days

• Research summary

  Manny Emergency Department doctors readily admit to a lack of confidence when diagnosing the dizzy patient acutely. The most frequent diagnostic errors in patients presenting with dizziness to the ED concerned vestibular neuritis and stroke. ED physicians worldwide rank vertigo a top priority for developing better diagnostic decision rules. Making the correct diagnosis is important because the clinical outcome can be poor for patients with stroke who present with dizziness and are initially misdiagnosed. It is also distressing for patients to undergo unnecessary investigations (leading to increased anxiety) for a suspected stroke, when the condition can be treated with (in the case of BPPV) a bedside manoeuvre.
  The primary aim of this study is to explore the accuracy of an ‘ acute vertigo toolbox’ to promptly identify sinister causes of acute vertigo when applied by ED physicians in patients with isolated vertigo.

  Although acute vertigo is common, its actual incidence in acute settings is unknown, highlighting the need to define and quantify the problem in this country. The secondary aim of this investigation is to identify the commonest causes of acute vertigo.

  Fulfilling these aims will allow us to propose an evidence-based guideline for the triage and management of patients with acute vertigo in ED settings, where the biggest difference to long-term outcome in these patients can be made. Our study will therefore have a positive impact on the individual and - in the context of the current financial climate for the NHS - on society as a whole. The study will provide high-quality data to inform a larger prospective interventional study aimed at the management of acute vertigo in the emergency department, with a focus on prompt, accurate, and effective treatment of vestibular migraine, the second commonest cause of vertigo worldwide.

• REC name

  North West - Greater Manchester South Research Ethics Committee

• REC reference

  21/NW/0015

• Date of REC Opinion

  26 Feb 2021

• REC opinion

  Further Information Favourable Opinion