Last reviewed
2026-02-07
Workflow pack
Dizziness/vertigo triage workflow
Structured dizziness workflow prioritizing stroke/cardiac exclusion and safe outpatient follow-up boundaries.
Trust and governance
Use only within this workflow's defined scope and exclusions.
Clinical owner
Family Medicine Editorial Team
Risk tier
Medium
Review cadence
Every 6 months
Next due 2026-08-07
Review status
Current
Scope limits
Initial outpatient dizziness and vertigo triage with risk-based disposition.
Exclusions (escalate/redirect)
- Acute focal neurologic deficits or severe gait instability requiring emergency evaluation.
- Active hemodynamic instability or ongoing syncope pathway care.
References
Escalate-now emphasis (medium-risk workflow)
Treat red-flag findings as urgent. Escalate the care pathway early if concern persists or follow-up reliability is uncertain.
At a glance
Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.
Immediate actions
- Classify dizziness phenotype and assess for central neurologic warning signs.
- Evaluate orthostatic status, hydration, and medication contributors.
- Determine if symptom severity permits safe outpatient pathway.
Red flags / escalate now
- New focal neurologic findings, severe ataxia, or inability to ambulate safely.
- Syncope, chest pain, or unstable cardiopulmonary symptoms.
- Worsening trajectory with unreliable follow-up capacity.
First-line plan
- Address reversible contributors such as dehydration and medication effects.
- Use focused workup strategy based on dominant risk pattern.
- Provide explicit plan for reassessment if diagnosis remains provisional.
Follow-up and monitoring
- Arrange close follow-up for persistent or recurrent episodes.
- Escalate promptly for progression toward neurologic or cardiac instability.
- Reinforce return precautions for stroke-like symptoms or collapse.
Condition guidance
Referral checklists
Tools and calculators
Return precautions (patient script)
Suggested plain-language wording for safety-net counseling:
If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.
- Use with the specific red flags listed on this page.
- Confirm follow-up timing and where to go after-hours.
- Document that return precautions were reviewed and understood.
Visit-close checklist
- Document disposition, rationale, and unresolved diagnostic uncertainty.
- Give explicit return precautions and follow-up timeline before ending visit.
- Attach a relevant handout when available to reinforce adherence and safety-netting.