Table 2.
Information regarding testing and management processes documented in visits to the ED for dizziness and subsequently discharged.
| Total | All visits N, % N=3,522 |
Visits for episodic presentations N, % N= 1,484 |
Visits with BPPV diagnosis N, % N= 156 |
|---|---|---|---|
| Dix-Hallpike Test | |||
| Documented | 137 (3.9%) | 89 (6.0%) | 34 (21.8%) |
| Results a | |||
| Positive b | 94 (2.7%) | 67 (4.5%) | 29 (18.6%) |
| Negative | 37 (1.1%) | 22 (1.5%) | 3 (1.9%) |
| Unknown | 6 (0.2%) | 0 (0.0%) | 2 (1.3%) |
| Canalith Repositioning Maneuver | |||
| Documented as done c,d | 8 (0.2%) | 4 (0.3%) | 6 (3.9%) |
| Additional mention e | 9 (0.3%) | 8 (0.5%) | 9 (5.7%) |
| Consultations | |||
| Neurology | 16 (0.5%) | 8 (0.5%) | 0 (0.0%) |
| Otolaryngology | 2 (0.1%) | 2 (0.1%) | 0 (0.0%) |
| Head CT | 1,162 (33.0%) | 488 (32.9%) | 46 (29.5%) |
CT = computerized tomography
Positive or negative results were based on nystagmus in 15.3% (21 of 137), symptoms only in 11.7% (16 of 137), and unknown (e.g., described as “positive” or “negative” or results not reported) in 73.0% (100/137). None of the visits with positive test results described the characteristic nystagmus pattern of BPPV (i.e., up-beat torsional nystagmus).
When the test was positive, the side affected was documented in 47.9% (45 of 94) of visits.
The side that the maneuver was performed on was only documented in one visit.
The patient’s response to the maneuver was reported in 6 visits and all responses were based on symptoms (3 with documented improvement and 3 with no improvement).
In these 9 additional visits, the maneuver was mentioned but not documented as performed. One of these indicated that instructions for the maneuver were provided, whereas the others suggested follow-up care for the maneuver.