155 Vertigo 77 Definition Sensation or illusion of movement that can result from diseases of the inner ear or from dis- turbances of the vestibular centers or pathways in the central nervous system. Most vertigo has no definite cause or is thought to be due to a viral infection of the inner ear. Characteristics Loss of balance and a feeling of a spinning room that might be either continuous or intermit- tent, lasting from minutes to hours. Nausea and visual disturbances might accompany the sensation. Vertigo can be caused by a variety of entities, including middle ear disease, trauma, and toxic conditions (e.g., those caused by salicylates, alcohol, streptomycin, sun- stroke, postural hypotension, Meniere’s syndrome, cerebrovascular accident, or toxemia). A person feels either self or surroundings moving. Policy Evaluate employee in the occupational health unit and refer for medical treatment. Work re- strictions might be necessary based on employee’s job responsibilities (e.g., operating equip- ment or machinery, driving, or working at heights). Objectives Clinical Assessments and Interventions Referral for Medical Action ● Continued vertigo. ● Need for further evaluation. ● Altered level of consciousness, not acting appropriately, or difficulty arousing. Follow-up Actions ● Evaluate safety factors in current position when employee returns to work. ● Consider placing employee in alternate position if necessary. ● Discuss what to do if symptoms recur. Determine extent and severity of the problem. Provide symptom relief. ● Assess head, ears, eyes, and throat. ● Record brief history of vertigo, including problems related to hearing loss, Meniere’s disease, use of ototoxic agents (alcohol, heavy metals, carbon monoxide, certain antibiotics, furosemide, quinine, or aspirin), risk factors for cerebrovascular accident, and noise. ● Instruct employee to sit or lie down until sensation passes. Guideline continues on next page