Apparent Life-Threatening Events in Infants: Deciphering Need for Admission

A three-variable model helps predict need for admission but lacks adequate sensitivity to safely send patients home.

To identify factors that predict safe emergency department (ED) discharge of infants with apparent life-threatening events (ALTEs), investigators prospectively enrolled 832 patients (median age, 31 days) who presented to four EDs during a 28-month period with at least two ALTE criteria (breathing irregularity, color change, or marked change in muscle tone). Patients were classified as “obviously needing admission” if they required oxygenation, ventilatory support, cardiopulmonary resuscitation, antibiotics for serious bacterial infection, hemodynamic support, or antiepileptic medication or if they tested positive for respiratory syncytial virus or pertussis.

Overall, 21% of patients had a history of prematurity, 26% had other “significant” m…

Reviewing Author

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)