Documentation of Nystagmus Assessment in Acute Vertigo: A Retrospective Audit of Emergency Department Practice and Variability in Two Regional Australian Hospitals

Vertigo is a common emergency department (ED) presentation. Assessment can be challenging due to various etiology and subtle clinical signs. Nystagmus is an important clinical feature, yet documentation of its key descriptors is often incomplete. OBJECTIVES: This study aimed to evaluate the documentation of nystagmus characteristics in patients presenting with acute vertigo to two regional EDs....

Audiologists and vestibular specialists should be aware that ED nystagmus documentation is frequently incomplete, meaning referral notes from emergency settings may not reliably capture key diagnostic information for vestibular triage.

Inconsistent ED nystagmus documentation represents a systemic gap that may delay accurate vestibular diagnosis and appropriate specialist referral across the care pathway.

1. 01Retrospective audit across two regional Australian EDs examining nystagmus documentation in acute vertigo cases.
2. 02Significant variability found in how—and whether—nystagmus assessments were recorded by ED clinicians.
3. 03Poor documentation may impede accurate differentiation between central and peripheral vertigo causes.
4. 04Findings highlight a need for standardised ED assessment and documentation protocols for acute vertigo.
5. 05Study is limited by its retrospective design and regional scope (two hospitals only).

PMID

42269255

DOI

10.1016/j.jemermed.2026.04.020.

Journal

Journal of Emergency Medicine

Publication type

research_article

Evidence level

4

Population

Patients presenting to two regional Australian emergency departments with acute vertigo

Intervention

Retrospective audit of ED nystagmus assessment documentation practices