Management of the dizzy patient at King Fahd Hospital of the University : an internal audit

Abstract EN

The quality of service provided to the dizzy patient who attend the ENT clinic at King Fahd Hospital of the University, Al-Khobar, is reviewed and the medical records critically analysed.

Out of a clinic population ofl6,000 patients (ENTclinic^tndancefor two years, 1988-1989), 110 complained of dizziness (0.7 %).

This Internal Audit suggests that the best way to deal with patients complaining of dizziness is to establish a n™itidisc؛pl؛nary clinic with well structured proce-durai protocol.

Dzziness is a common complaint among patients attending the Ear, Nose and throat (ENT) clinics.

At times, the syndrome of vertigo and dizziness may even be life threatening.

The symptoms affect a disturbance of orien-tation of the body in space; the resultant feeling is of subjective nature, and is usually controlled by a compli-cated stato-kinetic and propioceptive system‘.

While the problem may lie in any single component of the systems to produce clinical symptoms of dizziness, a true vertigo is an exclusive manifestation of disturbed stato-kinetic sysem2.

Because the controlling system is complex, it is not surprising that dizziness as a symptom may be very con-fusing.

However, once the function of this system is understood, it is possible to classify dizziness according to recognisable aetiological entities, that is otological, neurosurgical, medical and others3.

To accomplish localisation, a certain scheme of guidelines needs to be followed.

This appears to be the most practical pathway towards rational investigative and therapeutic regimen.

In an ideal situation a multi-disciplinary (ENT, Neurosurgery and Medical) clinic for the dizzy patient with a well structured procedural and investigative proto-col should be available and functioning Before taking such a decision we thought that it would be advisable first to review the charts of our dizzy patients in the previous 2 years, having in mind the following objectives: 1.

To know roughly the number of dizzy patients attending the ENT - Clinic.

2.

To have some insight of quality of service pro-vided to the patient (history, clinical examina-tion, investigations, treatment and follow up).

3.

To analyse all patient’s data with critical apprai-sal of the quality of services (internal audit).

And accordingly draw conclusions to improve the quality of services to the dizzy patient.