CHECKLIST FOR ADULT REFERRAL FOR DIZZY PATIENTS
For patients with dizziness.
If answer to any of below in Table 1 is “yes” refer to ENT consultant1
Table 1
Sudden onset of unilateral or rapid progression of sensory neural
hearing loss
Severe tinnitus for more than six weeks
Discharging ears2
Otalgia
Progressive unsteadiness or falls
Reason for referring if answering ‘No’ to any of above:-
Yes/No
Otherwise determine the nature of the dizziness and refer to balance clinic (joint
audiology/physiotherapy service, or existing physiotherapy service)
Table 2
Is the symptom vertigo?
Is the symptom a sensation of light-headedness or giddiness3
Do the symptoms occur with specific head movement?4
Reason for referring if answering ‘No’ to any of above:-
Yes/No
The following “red flags” are indications for immediate referral to a consultant
specialist (Action on ENT, 2003)
2
If patient has discharging ears, please see ‘Discharging ears’ checklist
3
if this triggered or exacerbated by sitting or standing position consider other
causes of presyncope
4
Dix-Hallpike Test positive
1