Benzo for Dizziness

[DwayneEMTP]

Shoot..no harm in laughing brother! Some of my greatest learning experiences have involved me looking like a monkey humping a football...

But you're right..I learned a lot of good lessons that day, and though I partially boneheaded the call there have been many patients that have benefited from that mans discomfort.

The ER doc was really cool. I said (As I seem to have this need to go, "Hey! Look at what an idiot I am!" any time I make a significant mistake.), "You know what Doc, he was resting ok, but then I tried to see what was happening and made him really, really freaked out and sick...Could I have verified this another way?" He said, "You know what? Don't play the "I'm a fucking retard" game. At least you bothered to check. Vertigo sucks, you made it suck less..I'm calling that a good run."

Of course he didn't really tell me if there was another way to verify it without making my patient wish he was dead, but after that I simply medicated based on vertigo symptoms, or symptoms in the issue specific recent history, and lacking a high index of suspicion for other pathologies and the patients have always sat up within a few minutes, cautiously twisting their neck this way and that to see if they were going to freak out again...so I call that good and leave it the hell alone!! :-)

Good thread, if maybe a bit off track...

Dwayne

[uglyEMT]

Sorry if this derailed the thread a little bit but felt it was pertenant enough to add.

Never heard of it as Top Shelf Vertigo but will keep it in mind.

Dwayne as an aside I will say this, as a sufferer myself, you did the guy a favor. Yea it probably sucked in that moment for both you and the patient BUT by helping diagnose it as BPPV you helped both the ED Doc and probably his GP give a better course of treatment. Being it is transient alot of times Docs have a hard time giving a good course of treatment (personal observation, maybe I have an asshat as a GP). Took mine 5 tries to get it right but now I am asymptomatic 4 years.

To Lone's question, yes I would tone out ALS just incase. Hearing from others that they would still push meds makes me believe it IS an ALS call not just a BLS call. Just as Dwayne gave an example things can go south quickly and having the ALS option to push meds makes sense. As for what about rig motion, usually (in my case at least) side to side, back and forth did nothing to set it off. Looking up or tilting my head back is what set it off so I wouldn't think normal motion of the rig traveling down the road would do anything.

[croaker260]

To Lone's question, yes I would tone out ALS just incase. Hearing from others that they would still push meds makes me believe it IS an ALS call not just a BLS call. Just as Dwayne gave an example things can go south quickly and having the ALS option to push meds makes sense. As for what about rig motion, usually (in my case at least) side to side, back and forth did nothing to set it off. Looking up or tilting my head back is what set it off so I wouldn't think normal motion of the rig traveling down the road would do anything.

Also keep in mind that a significant number of "vertigo" are actually atypical CVA presentations (aneurysms) , another reason for ALS.

[ERDoc]

I think the whole vertigo issue is a good reminder to all ALS providers (not directed at anyone specifically). Just because something is not life threatening does not mean it is not ALS. Being an ALS provider means more than just running the blood and guts, circling the drain, exciting, life threaning calls. It means running the call and treating the pt.