Aim
- to ensure patients who present with dizzy symptoms at rural or remote emergency departments are streamed to the most appropriate care pathway to treat vestibular conditions from initial diagnosis aiming to reduce the number of representations in Queensland emergency departments
- to reduce unnecessary patient medevac transport for patients with benign conditions, whilst ensuring early intervention and transport for those patients displaying serious neurological symptoms
- to improve the differential diagnosis of serious causes of vertigo.
Outcomes
ENT patients in rural and remote areas are receiving the most appropriate care in the management of emergent vertigo.
Vesticam infra-red video goggles have been trialed in five remote emergency departments, Weipa, Cooktown, Mt Isa, Longreach and Goondiwindi hospitals. These facilities have access to an e-consult platform to request advice and upload video images captured with the Vesticam goggles. This has been funded by the Healthcare Improvement Unit.
Background
Dial-a-Dizzy is a Statewide Telehealth Diagnostic Advisory Hotline to guide management of emergent dizziness or vertigo. Dial-a-Dizzy enables the local emergency doctor (and eventually GP) to contact the Consultant/Advanced Vestibular Physiotherapist and the Specialist ENT Consultant at Logan Hospital. Using the infra-red goggles, clinicians will be able to observe the eye movements to more clearly investigate the cause of dizziness. Once a cause is suspected/identified, the Dial-a-Dizzy team will recommend the appropriate treatment plan.
Dizziness accounts for approximately four per cent of chief complaints to the emergency departments in Queensland’s public hospitals. Patients who present with dizziness usually require specialist tests to determine if caused by the inner ear, (not dangerous) or a stroke, (very dangerous). When the cause is unclear patients living in rural or remote regions of Queensland may need to travel long distances to a tertiary hospital for further testing, taking patients away from family and support networks and increasing costs on the public health system.
Although significant progress in primary prevention and urgent care has improved stroke incidence and survival, there is scope to achieve more and to reduce costs for both ischaemic and haemorrhagic stroke e.g. through better stroke prevention. Substantial costs of stroke prevalence underline gaps in evidence-based cost-effective rehabilitation interventions [[23]], which could improve functioning and quality of life, reduce stroke recurrence and reduce need for longer-term care.
