Hey folks, Scott Wygard here, and this is an M-Crit Wii. Now, despite this being a we, I'm still giving continuing medical education credit for this episode to the MCRIT team members because I was not able to do it for that surviving sepsis campaign episode due to conflicts of interest by the lead author.

So check out your CME area to get credit for this episode.

What we're going to be talking about today is more on dizziness and vertigo. Essentially,

the title is you don't understand dizziness and vertigo, but you need to. Otherwise,

your patients are at risk. Now, what spurred this episode is I did a segment on MRAP. Some things were said on

MRAP that I didn't necessarily agree with or I wanted to give a little bit more context and

understanding and I recorded a segment with my buddy, Swami Nathan, and I thought it was really

important stuff, so I wanted to get it out here. And it will actually come out here before it comes out on MRAP.

I try not to leave too much overlap, but this one was actually crucial, I think, that people

understand, because there's been some new decision rules put out that I think if you use

them, you're potentially putting yourself and your patience at harm.

Okay, so we are bad at dizziness. Now, I have many papers to

support that contention, but I'll just mention one of them here. And this is the diagnostic

accuracy of the HINS exam in an emergency department, a retrospective chart review. And this is

pretty hysterical. Ninety-seven percent of the patients did not meet criteria for receiving the test as described, meaning that

it wasn't even that they did the hints wrong, and they probably did, but they were doing

it in the wrong patients.

Now, either case, doing it wrong or doing it in the wrong patients really has a chance to

send you astray and do either an unnecessary

workup, which would be bad and a waste of resources, waste of time of your patient, or the

wrong workup, which might actually cause you to miss a life-threatening illness. So this is just,

it's deplorable. In many cases, patients receive both the Hints exam and the Dix

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