Vertigo - Epley manoeuvre from BMJ Learning скачать в хорошем качестве

Vertigo - Epley manoeuvre from BMJ Learning

Take the full BMJ Learning module on vertigo: https://bit.ly/epsley The Epley manoeuvre can also be diagnostically helpful because repeated treatment failures using the Epley manoeuvre may suggest that the provisional diagnosis of BPPV may be incorrect. You should explain the procedure to the patient, and warn them that they may experience vertigo symptoms during it, but that the symptoms usually subside quickly. You should ask them to keep their eyes open throughout. Check that the patient does not have any neck injuries or other contraindications to rapid spinal movements - you need to execute movements during the procedure rapidly (in less than one second) Ask the patient to sit on an examination couch with their legs extended, close enough to the edge so that their head will hang over the edge when they lie down Stand on the side of the affected ear, take hold of the patient’s head with both of your hands, and turn their head 45° towards you. Hold until nystagmus dissipates Keeping their head in that position, lean the patient back rapidly until their head is over the edge of the couch. Hold until nystagmus dissipates Rotate the patient’s head through 90°, away from the side of the affected ear. Hold until nystagmus dissipates. Ideally, the patient’s head should be below the horizontal at all points when it is turned Keeping their head steady with both of your hands, ask the patient to roll their body onto their side, away from the affected ear. While the patient is turning, turn their head a further 90°, so that it faces the floor. Hold until nystagmus dissipates While keeping the patient’s head turned to the side, help them to sit up. Hold until nystagmus dissipates With the patient sitting up, move their head into the centre line, as you move it forward 45° (chin on chest). Hold until nystagmus dissipates.