Dizziness/vertigo Referral Access Criteria

• Sudden onset of debilitating dizziness/vertigo with associated neurological symptoms should raise the possibility of stroke
• Sudden onset of dizziness/vertigo with associated hearing loss and/or tinnitus
• Sudden onset of dizziness/vertigo with ear pain/discharge/trauma/barotrauma (please also contact the ENT registrar to advise patient will present to ED)

• Nil

• Positional vertigo lasting seconds to minutes (suspicion of benign paroxysmal positional vertigo (BPPV)
• First episode of acute vertigo lasting hours with no other obvious cause (suspicion of vestibular neuronitis)
• First episode of acute vertigo lasting hours with hearing loss (suspicion of vestibular labyrinthitis)
• Unilateral tinnitus, unilateral hearing loss, fluctuating hearing, aural fullness, and at least 2 episodes of vertigo lasting more than 20 minutes (suspicion of Meniere’s disease)
• Episodic vertigo with autophony, nose blowing/straining or noise induced vertigo (suspicion of perilymph fistula / superior canal dehiscence)

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

• Relevant history, onset, duration, frequency of symptoms including:
  • Episodic or continuous associated ear / tinnitus / hearing /neurological symptoms
• Degree of functional impairment (e.g. quality of life)
• Details of current and previous treatment and outcome
• Previous investigations/imaging results
• Current medication list
• Relevant medical history including:
  • History of ear surgery

• Description of findings:
  • ear canal and ear drum
  • vestibular examination (including Dix Hallpike test)
  • nystagmus assessment

• Audiology and audiogram results (where available and providing it will not cause significant delay)
• Outcome of any vestibular physiotherapy assessment (where available and providing it will not cause significant delay)

• History of any of the following:
  • cardiovascular problems
  • neck problems
  • neurological conditions such as migraine
  • auto immune conditions
  • eye problems
  • previous head injury            

• Nil

• Nil

Category 1

Appointment within 30 days

• Perilymph fistula

Category 2

Appointment within 90 days

• Meniere’s disease
• Benign paroxysmal positional vertigo (BPPV) refractory to repeated canalith (Epley) repositioning manoeuvres
• Vestibular labyrinthitis            

Category 3

Appointment within 365 days

• Superior canal dehiscence
• Chronic dizziness / vertigo not responding to vestibular physiotherapy
• Vestibular neuronitis
   

• Undifferentiated dizziness
  • If the referral is sent with no description of the dizziness, then the referral will be rejected

• Nil