Síguenos en Twitter     Síguenos en Facebook     Síguenos en Google+     Síguenos en YouTube     Siguenos en Linkedin     Correo Grupsagessa     Gmail     Yahoo Mail     Dropbox     Instagram     Pinterest     Slack     Google Drive     Reddit     StumbleUpon     Print

SOBRE EL AUTOR **

Mi foto
FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

EMCrit Podcast 208 – Felipe Teran on Why We are Doing CPR Wrong

Buscar en contenido

Contenido:

jueves, 31 de marzo de 2016

Approach to Dizziness

emDocs - March 31, 2016 - Author: Lotstein J. - Edited by: Koyfman A. and Long B.
"Summary
The dizzy patient can be a difficult patient encounter with multiple dangerous diagnoses to consider. While many patients are unable to reliably describe whether they are suffering from presyncope or vertigo (and thus may require an evaluation for both entities), some will provide historical clues or descriptors that will allow a narrowing of the differential at this initial step. As always, immediate life-threatening conditions must be considered such as arrhythmias, hemorrhage, or sepsis. Many of these conditions will be readily apparent on either the initial vital signs (including blood glucose and telemetry/EKG) or with basic labs (such as a CBC and a BMP). If the patient describes true vertigo, a thorough neurologic exam is key and the HiNTS exam (best in the patient with acute vestibular syndrome), while difficult for the inexperienced practitioner, has been shown to have excellent sensitivity and specificity for acute stroke. With practice, one should find him/herself comfortably able to navigate the treacherous waters of the “weak and dizzy” and be able to safely decide on the appropriate disposition of these patients."

También te podría interesar:
TOKC Blog / Morning report 6/18/2013 - by jkhadpe
"What is the HiNTS exam?
A set of 3 tests used to specifically differentiate central from peripheral etiology in setting of acute vestibular syndrome/ AVS (rapid onset (seconds to hours) of vertigo, nausea/vomiting and gait unsteadiness with head-motion intolerance and nystagmus lasting days to weeks. BPPV is not in the differential of AVS, because, according to the authors, BPPV should last less than 24hrs).
  • Hi = Head impulse testing
  • N = Nystagmus
  • TS = Test of skew
"Check out the links below for videos of the exam, and a great PV card from Dr. Lin at ALIEM."