Emergency Medical Minute8 Loka 2018

Podcast #389: BRUE

Educational Pearls:

BRUE (Brief Resolved Unexplained Event) replaces what was previously called ALTE

BRUE describes an event in a child less than one year of age with one or more of the following:
- cyanosis or pallor
- absent, decreased, or irregular breathing
- decreased or increased tone
- altered responsiveness

These must be sudden, brief, and now resolved and without an alternative explanation after a history and physical exam

Low risk patients can be safely discharged with reassurance

Low risk criteria must all be present:
- Age over 60 days old
- >32 weeks gestational age at birth and adjusted gestational age > 45 weeks)
- No CPR was performed (by a trained medical professional)
- First event
- Duration less than 1 minute of event

Patients who satisfy above criteria can be considered low risk and may be discharged after minimal/no workup

References:

Tieder JS, Bonkowsky JL, Etzel RA, et al. 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. Pediatrics. 2016 Aug;138(2). pii: e20161488. doi: 10.1542/peds.2016-1488. PubMed PMID: 27474017.

Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD

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