Sudden Infant Death Syndrome

Question 1

An episode that is frightening to the observer; combination of apnea, color change, marked change in muscle tone or choking or gagging

Answer 1

Acute Life- Threatening Events (ALTE)

Question 2

Event occurring in an infant less than 1 year who is reported to have a “sudden, brief, and now RESOLVED episode of ONE OR more of the following: (1) cyanosis or pallor; (2)absent, decreased, or irregular breathing; (3) marked change in tone (hypertonia or hypotonia); and (4) altered level of responsiveness.

Answer 2

Brief, Resolved Unexplained EVENT (BRUE)

Question 3

BRUE Criteria (lower risk criteria)

Answer 3

More than 60 days
Prematurity: ≥32 weeks and >45 weeks PCA
First BRUE
Duration less than 1 minute
No (CPR) required
No concerning historical features
No concerning physical examination findings

Question 4

infants whose ALTE resembles apnea after choking have an exaggerated

Answer 4

Laryngeal chemoreflex
o Apnea beginning within 0.25 seconds of the stimulus may last 20–90 seconds and may be fatal in the laboratory
o Saline elicits little or no response
o Water and cow’s milk elicit a dramatic LCRA

Question 5

AAP recommendation to monitor 2 specific circumstances

Answer 5

premature infants until “43 weeks PCA,” or until “extreme episodes” of apnea, bradycardia, and hypoxemia stop;

infants who are usually supported at home by mechanical ventilation through a tracheotomy.

Question 6

Apnea in premature infants

Answer 6

cessation of airflow for 10–20 seconds or longer

Question 7

stimulated by noxious agents, such as temperature, ammonium, capsaicin, and H+ ions-

Answer 7

C fibers

Question 7

stimulated by noxious agents, such as temperature, ammonium, capsaicin, and H+ ions-

Answer 7

C fibers