Hello, med students. My name is Zach Olson, and thank you for downloading this episode of the EM Clerkship Podcast.

Today we are covering a topic that is very near and dear to my heart, Vertigo, because my very first patient as an intern was actually a patient who was really dizzy

and I had no idea what to do. It was one of many residency moments where you could just kind of

pause and think and you get that like, oh no, what did I get myself into type feeling. I mean,

it could have been like chest pain or a stroke, but no, like the patient

had severe vertigo. First day on my own, my very first patient ever is he's crying and

vomiting and complaining of how dizzy is, Zach, fix it. So, I mean, that was my welcome to

emergency medicine. Today, I'm going to help you with this chief complaint.

It's a very tricky chief complaint, actually.

I still think it's kind of difficult.

But as a med student, you just really need to know a few basic steps.

It all comes down to, does this patient have central vertigo,

aka like the bad vertigo, the brain vertigo, or peripheral

vertigo, the not bad vertigo?

Every single step today is trying to identify central vertigo versus peripheral vertigo.

That's the whole game here.

Even before that, though, we need to clarify a few things.

Vertigo versus lightheadedness. Because dizziness literally means nothing to your attending.

Don't ever say dizzy. It's either vertigo or lightheadedness. Lightheadedness is that feeling of

wooziness or like the patient's going to fall down,

lose consciousness. And this tends to be more of a cardiovascular type of complaint, whereas

vertigo is the sensation of movement when none exists. So you have to ask the patient, is the,

...