Dizziness-Vertigo Ambulatory

Clinical Pathways promote evidence-based, safe, and high-value patient care by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by a methodical review of available evidence and consensus among committee members. 

Dizziness-Vertigo Clinical Pathway: 

• Dizziness-vertigo-ambulatory algorithm
• Dizziness-vertigo-ambulatory synopsis (provides care standards employed for this clinical pathway) 

 Inclusion and exclusion criteria: 

• Inclusion: 
  • Patient with complaint of symptoms consistent with dizziness or vertigo
• Exclusion: 
  • Acute illness with associated dizziness or vertigo
  • Syncope
  • Known concussion or recent head injury
  • Known Positional Orthostatic Tachycardia Syndrome (POTS) 

 Committee members involved in the development: 

• Trisha Williams, RN, APRN, CPN, CPNP | Otolaryngology | Committee Co-Chair
• Lara Koral, MSN, FNP-BC | Neurology | Committee Co-Chair
• Katie Senn, MD | General Academic Pediatrics | Committee Member 
• Rachel Whitfield, MSN, APRN, FNP-C | Adolescent Medicine | Committee Member
• Stacey Shoman, APRN | Premier Pediatrics | Committee Member 
• Andrea Thorne, PT | Physical & Occupational Therapy | Committee Member

Consultants: 

• Stephani Stancil, PhD, APRN | Adolescent Medicine, Clinical Pharmacology and Toxicology 
• Julie Martin, RN, MSN, FNP-BC, PNP-BC | Heart Center
• Laura Martis, MSN, RN, CPNP-AC | Heart Center
• Lindsey Malloy Walton, DO, MPH | Heart Center
• Amanda Nedved, MD | Urgent Care 
• Gina Jones, DO | Neurology
• Trevor Gerson, MD | Neurology 
• Joseph Ursick, MD | Otolaryngology
• Michael Puricelli, MD | Otolaryngology

EBP Committee Members: 

• Kathleen Berg, MD, FAAP | Hospitalist, Evidence Based Practice
• Andrea Melanson, OTD, OTR/L | Evidence Based Practice 

 Publication dates: 

• Finalized date: 04/2025
• Next expected revision date: April 2028 

 Concerns with content: 

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.  

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.