[75] Apparent Life-Threatening Event Flashcards

1
Q

What is an apparent life-threatening event (ALTE)?

A

Where there is sudden, brief, and often frightening changes in the condition of an infant who was previously well and appear well immediately after

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2
Q

How may ALTE present?

A
  • Cyanosis or pallor
  • Absent, decreased or irregular breathing
  • Change in tone
  • Altered level of responsiveness
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3
Q

What additional features make a likely diagnosis of ALTE?

A

No concerning features on detailed history (including social history) and physical examination

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4
Q

What investigations are typically performed?

A
  • ECG
  • Nasal swabs for pertussis
  • Monitoring of pulse oximetry
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5
Q

What are the differntials for ALTE?

A
  • GORD
  • Pertussis
  • LRTI
  • Seizure
  • UTI
  • Factitious illness including FII
  • Cardiac arrhythmia e,g, long QT syndrome or SVT
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6
Q

What is required in children with ALTE?

A

A period of baseline obs monitoring

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7
Q

What will caregivers need?

A

An explanation of the condition and BLS training

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8
Q

Should follow-ups be arranged?

A

Yes

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9
Q

What should be done if the features are not characteristic of ALTE?

A

Further assessment and investigation

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10
Q

What may cause suspicion of an underlying disorder?

A
  • Age <60 days
  • Gestation at birth <32 weeks
  • Duration >1 min
  • Repeat event
  • CPR given by trained medical provider
  • Concerning features of history
  • Abnormalities on physical examination
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11
Q

What features of a history may make you think ALTE has an underlying cause?

A
  • FH of cardiac death
  • Child protection concerns
  • Cough or breathing suggestive of RTI
  • Vomiting suggestive of GORD
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12
Q

What features of physical examination may make you think ALTE has an underlying cause?

A
  • Fever

- Respiratory distress

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