STANDING update: A retrospective analysis in the Emergency Department one year after its validation

  • Alice Ceccofiglio Syncope Unit, Department of Geriatrics, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy.
  • Rudi Pecci | peccirudi@gmail.com Unit of Audiology, Head and Neck Oncological and Robotic Surgery, Oncology and Robotic Surgery Department, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy.
  • Giulia Peruzzi Syncope Unit, Department of Geriatrics, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy.
  • Giulia Rivasi Syncope Unit, Department of Geriatrics, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy.
  • Martina Rafanelli Syncope Unit, Department of Geriatrics, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy.
  • Simone Vanni
  • Andrea Ungar Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy.

Abstract

A structured four-step bedside algorithm, named SponTAneous Nystagmus, Direction, head Impulse test, standiNG (STANDING), has been proposed to differentiate central from peripheral acute vestibulopathy in the Emergency Department (ED). We aimed to evaluate the effective application of STANDING in the management of vertigo in the ED and to define its role in deciding the patient’s pathway after discharge. We retrospectively analysed data from 131 consecutive patients (65% female, mean age 56) undergoing ED visits for a vertigo complaint between April and May 2016. Our study showed that the STANDING algorithm is underused, being performed only in the 18% of patients. The positivity of the STANDING did not influence the choice of the following pathway (e.g. outpatient fast track or discharge). Moreover, a small percentage of patients had a non-audiological diagnosis (mainly presyncope), for which no defined pathways were yet foreseen. Our study emphasized the need for continuous updating with appropriate training courses and the importance of a multidisciplinary assessment of vertigo in the ED.

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Published
2020-08-31
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Original Articles
Keywords:
dizziness, vertigo, Audiology Unit, Syncope Unit
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How to Cite
Ceccofiglio, A., Pecci, R., Peruzzi, G., Rivasi, G., Rafanelli, M., Vanni, S., & Ungar, A. (2020). STANDING update: A retrospective analysis in the Emergency Department one year after its validation. Emergency Care Journal, 16(2). https://doi.org/10.4081/ecj.2020.8848