Brief resolved unexplained event - Revision history

Rossdonaldson1: /* External Links */

2021-10-06T14:49:52Z

External Links

← Older revision		Revision as of 14:49, 6 October 2021
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	==External Links==		==External Links==
	[http://dontforgetthebubbles.com/brue-is-the-new-black/ Brue - Don't forget the bubbles]<BR>		*[http://dontforgetthebubbles.com/brue-is-the-new-black/ Brue - Don't forget the bubbles]<BR>
	[http://thesgem.com/2019/12/sgem-xtra-strange-brue/ SGEM Xtra: Strange Brue from The Sketics' Guide to EM]		*[http://thesgem.com/2019/12/sgem-xtra-strange-brue/ SGEM Xtra: Strange Brue from The Sketics' Guide to EM]

	==References==		==References==

Farmersj333: /* Risk Factors */

2020-12-22T02:19:00Z

Risk Factors

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	*History of apnea		*History of apnea
	*Pallor, cyanosis, feeding difficulties		*Pallor, cyanosis, feeding difficulties
	*Family hx of ~~SCD~~		*Family hx of sudden cardiac death

	==Clinical Features==		==Clinical Features==

Farmersj333: /* Risk Factors */

2020-12-22T02:18:26Z

Risk Factors

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	*History of apnea		*History of apnea
	*Pallor, cyanosis, feeding difficulties		*Pallor, cyanosis, feeding difficulties
			*Family hx of SCD

	==Clinical Features==		==Clinical Features==

Farmersj333: /* Background */

2020-12-22T02:14:56Z

Background

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	*Abbreviation: BRUE		*Abbreviation: BRUE
	*BRUE was formerly known as Apparent life-threatening event (ALTE)<ref name="aap">[https://www.ncbi.nlm.nih.gov/pubmed/27244835 Tieder et al. Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants. Pediatrics. May 2016, Vol. 137(5)]</ref>		*BRUE was formerly known as Apparent life-threatening event (ALTE)<ref name="aap">[https://www.ncbi.nlm.nih.gov/pubmed/27244835 Tieder et al. Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants. Pediatrics. May 2016, Vol. 137(5)]</ref>
	*BRUE definition has a strict age limit and should only be considered if no other likely explanation.		*BRUE definition has a strict age limit (<1 y/o) and should only be considered if no other likely explanation
	*Peak incidence: 1 wk - 2 mo		*Peak incidence: 1 wk - 2 mo
	*BRUE is a symptom and requires evaluation for the actual diagnosis causing the event		*BRUE is a symptom and requires evaluation for the actual diagnosis causing the event

Rossdonaldson1: /* Diagnosis */

2020-01-06T23:07:41Z

Diagnosis

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	===Diagnosis===		===Diagnosis===
			''See Definition in Background section''
	====Low Risk Criteria<ref name="aap"></ref>====		====Low Risk Criteria<ref name="aap"></ref>====
	*Age >60 days		*Age >60 days

Rossdonaldson1 at 23:02, 6 January 2020

2020-01-06T23:02:59Z

← Older revision		Revision as of 23:02, 6 January 2020
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	*Extensive list of physical exam features be considered from [https://pediatrics.aappublications.org/highwire/markup/111147/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 3 of the original BRUE article.]<ref name="aap"></ref>		*Extensive list of physical exam features be considered from [https://pediatrics.aappublications.org/highwire/markup/111147/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 3 of the original BRUE article.]<ref name="aap"></ref>

	==~~Pertinent~~ History==		===Past Medical History===
	''The history in an BRUE should focus extensively on the details surrounding the event, need for resuscitation, prior events, possible related medical conditions, or historic findings that may indicate prior events.''		''The history in an BRUE should focus extensively on the details surrounding the event, need for resuscitation, prior events, possible related medical conditions, or historic findings that may indicate prior events.''

	~~===Past Medical History===~~
	*Prematurity, history of apnea, prior resp/feeding difficulties		*Prematurity, history of apnea, prior resp/feeding difficulties
	*Immunization status (particularly pertussis)		*Immunization status (particularly pertussis)

Rossdonaldson1: /* Differential Diagnosis */

2020-01-06T23:02:05Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	The differential diagnosis is extensive, and although a broad workup is often started in the ED including evaluation for sepsis, occult infection, and metabolic disorders, a cause is infrequently found<ref>McGovern MC. et al. Smith MB. Causes of apparent life threatening events in children: a systemic review. Arch Dis Child. 2004;89(11):1043-1048</ref>		''The differential diagnosis is extensive, and although a broad workup is often started in the ED including evaluation for sepsis, occult infection, and metabolic disorders, a cause is infrequently found<ref>McGovern MC. et al. Smith MB. Causes of apparent life threatening events in children: a systemic review. Arch Dis Child. 2004;89(11):1043-1048</ref> ''
	===Common<ref>Okada K et al. Discharge Diagnoses in infants with apparent life threatening event admissions and gastroesophageal reflux disease. Pediatric Emergency Care. 2012;28(1):17-21</ref>===		===Common<ref>Okada K et al. Discharge Diagnoses in infants with apparent life threatening event admissions and gastroesophageal reflux disease. Pediatric Emergency Care. 2012;28(1):17-21</ref>===
	*Idiopathic (~50%)		*Idiopathic (~50%)

Rossdonaldson1 at 23:00, 6 January 2020

2020-01-06T23:00:46Z

← Older revision		Revision as of 23:00, 6 January 2020
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	*Only 10% have repeat events		*Only 10% have repeat events
	*BRUE is not related to [[SIDS]]		*BRUE is not related to [[SIDS]]

	===Definition===		===Definition===
	BRUE diagnosis is only made by a clinician based on the features and is not based on the caregiver's perception of what happened. BRUE is an event occurring in an infant <1 year of age when an observer reports a sudden, brief '''( <1 minute but typically <20–30 seconds)''', and now resolved episode of ≥1 of the following:<ref name="aap"></ref>		BRUE diagnosis is only made by a clinician based on the features and is not based on the caregiver's perception of what happened. BRUE is an event occurring in an infant <1 year of age when an observer reports a sudden, brief '''( <1 minute but typically <20–30 seconds)''', and now resolved episode of ≥1 of the following:<ref name="aap"></ref>
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	==Clinical Features==		==Clinical Features==
	''See definition above''		''See definition above''
			*Extensive list of historical features to be considered from [https://pediatrics.aappublications.org/highwire/markup/111204/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 2 of the original BRUE article.]<ref name="aap"></ref>
			*Extensive list of physical exam features be considered from [https://pediatrics.aappublications.org/highwire/markup/111147/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 3 of the original BRUE article.]<ref name="aap"></ref>

	==Pertinent History==		==Pertinent History==
	''The history in an BRUE should focus extensively on the details surrounding the event, need for resuscitation, prior events, possible related medical conditions, or historic findings that may indicate prior events.''		''The history in an BRUE should focus extensively on the details surrounding the event, need for resuscitation, prior events, possible related medical conditions, or historic findings that may indicate prior events.''

	*Extensive list of historical features to be considered from [https://pediatrics.aappublications.org/highwire/markup/111204/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 2 of the original BRUE article.]<ref name="aap"></ref>

	===Past Medical History===		===Past Medical History===
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	==Evaluation==		==Evaluation==

	~~===Physical Exam===~~
	*Extensive list of physical exam features be considered from [https://pediatrics.aappublications.org/highwire/markup/111147/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 3 of the original BRUE article.]<ref name="aap"></ref>

	===Work-Up===		===Work-Up===
	====Low Risk====		====Low Risk====

Hoxbox: /* Physical Exam */

2019-12-08T11:14:22Z

Physical Exam

← Older revision		Revision as of 11:14, 8 December 2019
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	===Physical Exam===		===Physical Exam===
	*Extensive list of physical exam features be considered from [https://pediatrics.aappublications.org/highwire/markup/111147/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 3 of the original BRUE article.]<ref>[https://www.ncbi.nlm.nih.gov/pubmed/27244835 Pediatrics. 2016 May;137(5). pii: e20160590. doi: 10.1542/peds.2016-0590. Epub 2016 Apr 25. Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants. Tieder et al]</ref>		*Extensive list of physical exam features be considered from [https://pediatrics.aappublications.org/highwire/markup/111147/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 3 of the original BRUE article.]<ref name="aap"></ref>

	===Work-Up===		===Work-Up===
	====Low Risk====		====Low Risk====

Hoxbox: /* Pertinent History */

2019-12-08T11:13:35Z

Pertinent History

← Older revision		Revision as of 11:13, 8 December 2019
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	''The history in an BRUE should focus extensively on the details surrounding the event, need for resuscitation, prior events, possible related medical conditions, or historic findings that may indicate prior events.''		''The history in an BRUE should focus extensively on the details surrounding the event, need for resuscitation, prior events, possible related medical conditions, or historic findings that may indicate prior events.''

	*Extensive list of historical features to be considered from [https://pediatrics.aappublications.org/highwire/markup/111204/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 2 of the original BRUE article.]<ref>[https://www.ncbi.nlm.nih.gov/pubmed/27244835 Pediatrics. 2016 May;137(5). pii: e20160590. doi: 10.1542/peds.2016-0590. Epub 2016 Apr 25. Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants. Tieder et al]</ref>		*Extensive list of historical features to be considered from [https://pediatrics.aappublications.org/highwire/markup/111204/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed Table 2 of the original BRUE article.]<ref name="aap"></ref>

	===Past Medical History===		===Past Medical History===