Apparent Life Threatening Event (ALTE) – Now Called Brief Resolved Unexplained Event (BRUE): Help From Dr. Fox of Pediatric EM Morsels

Dr. Sean Fox, pediatric emergency physician, blogs at the excellent Pediatric EM Morsels.

His post, BRUE SEPTEMBER 2, 2016, discusses brief resolved unexplained events (BRUE) which used to be called apparent life threatening event (ALTE).

The post is full of outstanding tips and so I’ll go to his post,  BRUE (aka ALTE), whenever the diagnosis comes up.

Dr. Fox has posted other posts on ALTE all of which are great useful reviews and worth going over when you review his BRUE (aka ALTE post). They include ALTE in Neonate, and Apparent Life Threatening Event (ALTE).

The following resources are all from Dr. Fox’s post:

FOR ANOTHER PERSPECTIVE: 

See Dr. May’s post on St. Emlyns.

HERE ARE THE NEW PEDIATRIC GUIDELINES ON BRUE: 

Tieder JS, Bonkowsky JL, Etzel RA, Franklin WH, Gremse DA, Herman B, Katz ES, Krilov LR, Merritt JL 2nd, Norlin C, Percelay J, Sapién RE, Shiffman RN, Smith MB; SUBCOMMITTEE ON APPARENT LIFE THREATENING EVENTS.  Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Pediatrics. 2016 May;137(5).                                                 An error occurred in the American Academy of Pediatrics article, titled “Clinical Practice Guideline: Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants” . In the algorithm (Fig 1), under Management Recommendations for Lower-Risk Infants, “laboratory evaluation for anemia” should have appeared in the “Should Not” box, not the “Need Not” box. The corrected algorithm appears in the online version of this article.

HERE IS THE EXECUTIVE SUMMARY OF THE NEW PEDIATRIC GUIDELINES ON BRUE: 
Tieder JS, Bonkowsky JL, Etzel RA, Franklin WH, Gremse DA, Herman B, Katz ES, Krilov LR, Merritt JL 2nd, Norlin C, Percelay J, Sapién RE, Shiffman RN, Smith MB; SUBCOMMITTEE ON APPARENT LIFE THREATENING EVENTS. Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants: Executive Summary Pediatrics [PubMed Abstract] [Full Text HTML] [Full Text PDF]. 2016 May;137(5).

An error occurred in the American Academy of Pediatrics article, titled “Clinical Practice Guideline: Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants: Executive Summary” (Pediatrics 2016;137(5):e20160591; http://pediatrics.aappublications.org/content/pediatrics/137/5/e20160591.full.pdf). In the algorithm (Fig 1), under Management Recommendations for Lower-Risk Infants, “laboratory evaluation for anemia” should have appeared in the “Should Not” box, not the “Need Not” box. The corrected algorithm appears in the online version of this article.

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