Emergency: requires immediate attention
Brief resolved unexplained events in infant
Alerts and Notices
Synopsis

Infants who have had a BRUE are considered low risk for recurrence of a BRUE and are unlikely to have a serious life-threatening medical cause for the event if they meet all of the following low-risk criteria:
- The infant is older than 60 days; if premature, the infant was born at 32 weeks gestation or older and corrected gestational age at the time of the event is 45 weeks or older.
- The event was singular and lasted less than 1 minute.
- No cardiopulmonary resuscitation (CPR) was needed based on the assessment of a trained medical provider.
- There are no concerning features based on a thorough medical and social history, including but not limited to recent illness, significant past medical history, family history of sudden death / sudden infant death syndrome (SIDS) or similar event, or history of abuse or neglect.
- The patient has no prior history of a BRUE.
- The patient has a normal physical examination with normal, stable vitals over a period of observation of several hours with continuous pulse oximetry.
Codes
ICD10CM:R68.13 – Apparent life threatening event in infant (ALTE)
SNOMEDCT:
720975008 – Brief resolved unexplained event
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Bronchiolitis
- Respiratory syncytial virus (RSV) infection
- GERD
- Airway abnormality
- Seizure
- Breath-holding spell
- Neonatal urinary tract infection
- Inborn error of metabolism
- Cardiac arrhythmia
- Congenital cardiac disease
- Anemia
- Sepsis
- Meningitis (eg, viral, bacterial, fungal)
- Pertussis
- Pneumonia
- Child abuse (inflicted injury)
- Toxic ingestions – Although rare, it is possible to see brief symptoms that are not recurrent.
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:01/08/2023
Last Updated:03/09/2023
Last Updated:03/09/2023