OnlineMedEd: Pediatrics - "ALTE BRUE and SIDS"

Question 1

What is ALTE?

Answer 1

Apparent Life-Threatening Event

Question 2

When investigated, what are the common causes of ALTEs?

Answer 2

•50%: idiopathic
•50%:
- More common: GERD, Sz, LRI
- Less common: congenital heart disease, sepsis, NAT

Question 3

In addition to limb jerking, ask about ___________ in taking a seizure history in a child.

Answer 3

eye movements

Question 4

What are two important diagnostic criteria for BRUE?

Answer 4

• Must be brief (less than 1 minute)

* Must be in a child younger than 1

Question 5

The American Academy of Family Physicians now recommends dividing BRUEs into low-risk (which do not require a workup) and high-risk (which require a workup directed by history/physical). What are the criteria of a low-risk and high-risk BRUE?

Answer 5

•Low-risk:

• No cyanosis
• No fever
• No signs of abuse
• Episode resolved without intervention
• No history of other episodes
• Term baby greater than 60 days
• Preemie baby greater than 32 weeks gestational age and greater than 45 weeks post-conception

• High-risk:
- Anything that is not low-risk (i.e., any of the above features)

Question 6

What are the three things you need to recommend to reduce the risk of SIDS?

Answer 6

• Put babies to sleep on their backs
• Advise to not sleep in the same bed
• Have parents stop smoking