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Tuesday, September 20, 2022

HINTS Exam

SGEM#376 - September 17, 2022 - By admin
Reference: Gerlier C, et al. Differentiating central from peripheral causes of acute vertigo in an emergency setting with the HINTS, STANDING and ABCD2 tests: A diagnostic cohort study. AEM 2021
The paper we will discuss compares the HINTS exam to the STANDING protocol. STANDING is an algorithm by Dr. Vanni et al. published in Frontiers in Neurology 2017.


"CLINICAL QUESTION: CAN EMERGENCY PHYSICIANS LEARN AND PROPERLY USE VERTIGO PROTOCOLS TO ASSESS PATIENTS WITH ACUTE VESTIBULAR SYNDROME, AND IS ONE PROTOCOL BETTER THAN OTHERS?
KEY RESULT: IN THESE NINE TRAINED EMERGENCY PHYSICIANS, THE HINTS EXAM, AND THE STANDING ALGORITHM OUTPERFORMED ABCD2 IN DIAGNOSING CENTRAL CAUSES OF VERTIGO.
SGEM BOTTOM LINE: THIS STUDY SHOWS THAT EMERGENCY PHYSICIANS CAN USE THE HINTS EXAM TO RULE OUT STROKE ON PATIENTS WITH CONSTANT VERTIGO AND NYSTAGMUS, WHO SCREEN NEGATIVE FOR CENTRAL FEATURES OF VERTIGO, AND HAVE AN OVERALL HINTS PERIPHERAL RESULT"