To identify if peripheral vertigo patients receive the standard in-hospital care.

Our Neurology service was consulted on forty-nine patients with peripheral vertigo who presented to the ED in 2022. DHT was performed in 29 (53%). Symptomatic medical treatment was provided to 45 patients (91.8%); one patient received Intravenous fluids (IVF) only, five received Meclizine only, ten received a combination of 2 treatments (e.g., IVF + Meclizine), twelve received a variety of 3 treatments including antiemetics (e.g., IVF + Meclizine/Zofran+ valium), and 17 received at least 4 treatments. 27 patients (55.1%) were admitted to inpatient vs. 19 (38.7%) discharged from the ED at 0 day. Only 9/49 (18.3%) were referred to vestibular rehab upon discharge; of those, only 6.1% followed up. Seven patients (14.2%) presented a few days later with recurrent symptoms.

Our study highlights the deficiencies in the care provided to peripheral vertigo patients presenting to the ED and the importance of outpatient referral. This can prevent inappropriate repeated utilization of ED services. Suggested interventions include creating standardized management protocols including different maneuvers, vertigo cards with explanatory flow charts and ensuring proper referral to vestibular rehab.