Apparent Life-Threatening Event Flashcards
What is an apparent life-threatening event (ALTE)?
Where there is sudden, brief, and often frightening changes in the condition of an infant who was previously well and appear well immediately after
How may ALTE present?
- Cyanosis or pallor
- Absent, decreased or irregular breathing
- Change in tone
- Altered level of responsiveness
What additional features make a likely diagnosis of ALTE?
No concerning features on detailed history (including social history) and physical examination
What investigations are typically performed?
- ECG
- Nasal swabs for pertussis
- Monitoring of pulse oximetry
What are the differntials for ALTE?
- GORD
- Pertussis
- LRTI
- Seizure
- UTI
- Factitious illness including FII
- Cardiac arrhythmia e,g, long QT syndrome or SVT
What is required in children with ALTE?
A period of baseline obs monitoring
What will caregivers need?
An explanation of the condition and BLS training
Should follow-ups be arranged?
Yes
What should be done if the features are not characteristic of ALTE?
Further assessment and investigation
What may cause suspicion of an underlying disorder?
- 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
What features of a history may make you think ALTE has an underlying cause?
- FH of cardiac death
- Child protection concerns
- Cough or breathing suggestive of RTI
- Vomiting suggestive of GORD
What features of physical examination may make you think ALTE has an underlying cause?
- Fever
- Respiratory distress
