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Apparent life-threatening events in children: practical evaluation and management

Mia Sarohia, Shari Platt

    Pediatric Emergency Medicine Practice
    |May 20, 2014
    PubMed

    Insights

    Apparent life-threatening events (ALTEs) in infants require careful evaluation. Identifying high-risk factors and using targeted testing guides management to prevent adverse outcomes.

    Area of Science:

    • Pediatrics
    • Emergency Medicine

    Background:

    • Apparent life-threatening events (ALTEs) represent a significant portion of pediatric emergency department visits.
    • Identifying risk factors for serious underlying pathology in infants is crucial for appropriate management.

    Purpose of the Study:

    • To identify risk factors for serious underlying disease in infants presenting with ALTEs.
    • To provide guidance on thorough history taking and physical examination for these patients.
    • To outline diagnostic testing and hospital admission guidelines for infants with ALTEs.

    Main Methods:

    • This review synthesizes current literature on ALTEs in infants.
    • It focuses on risk stratification, diagnostic approaches, and management strategies.
    • Emphasis is placed on targeted evaluation rather than routine testing.

    Main Results:

    • Key risk factors include prematurity, underlying medical conditions, suspected abuse, seizure activity, and recurrent ALTEs.
    • A detailed history and physical exam are paramount.
    • Targeted diagnostic testing and a period of inpatient observation are often indicated.

    Conclusions:

    • A comprehensive approach involving risk assessment, thorough history, and targeted testing is essential for managing infants with ALTEs.
    • Guidelines are provided to aid clinicians in decision-making regarding further workup and disposition.

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