Does training therapists to manage benign paroxysmal positional vertigo in patients with acute traumatic brain injury reduce vestibular neurology referrals?

ABSTRACT

Objective

Dizziness is common in patients with acute traumatic brain injury (aTBI). However, patients are not always managed by the ward team but instead are referred to a visiting vestibular neurology team or referred for outpatient follow-up. We aimed to ascertain whether training trauma ward therapists to manage a common form of post-traumatic dizziness (Benign paroxysmal positional vertigo [BPPV]) reduced referrals to a visiting vestibular neurology team.

Design

Referrals of patients with aTBI with complaints of dizziness to the visiting vestibular neurology team were audited from the Major Trauma Centre at Imperial College Healthcare NHS Foundation Trust, London, UK. Ward therapists subsequently received training on management of BPPV. Referrals to the vestibular neurology service were re-audited. Therapist confidence in assessing and treating BPPV was also assessed pre and post-training.

Results

Pre-training, referral rate to the visiting vestibular neurology service was eight patients per month. Following training, referrals to the vestibular neurology service reduced by 35%. Therapist confidence improved significantly following training.

Conclusions

Training trauma ward therapists to manage BPPV reduced referrals to a visiting vestibular neurology service. Further research is necessary to assess implications for service and patient level parameters, such as length of stay and time to discharge.

KEYWORDS:

• Benign paroxysmal positional vertigo
• post traumatic dizziness
• acute traumatic brain injury
• allied health professionals

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Author RS is funded by a Clinical Doctoral Research Fellowship, ICA-CDRF-2017-03-070, supported by the National Institute for Health Research (NIHR) and Health Education England (HEE). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR, HEE or the Department of Health. a Clinical