 |  | Rudolph's Pediatrics Section 8. The Acutely Ill Infant and Child > Part 3. Injuries and Untoward Events > Chapter 119. Apparent Life-Threatening Events and SIDSMichael J. Corwin | |
Topics Discussed: acute illness; apparent life-threatening events in infants; cardiorespiratory monitors; sudden infant death.
Sections: References.
Excerpt:"There is considerable variation in the management of infants
admitted for apparent life-threatening event–type diagnoses
across US hospitals.29 A general strategy for management
of infants who have experienced a possible ALTE is provided in Figure 119-1. In the majority of cases, a
careful history and physical examination will suggest that the event was
either misinterpreted normal behavior or was relatively trivial
(eg, minor choking episodes). In these cases, families need reassurance
with a clear explanation of why no further intervention is needed
and, if appropriate, need advice regarding childcare practices that
will decrease the likelihood of recurrence (eg, proper feeding technique
to reduce choking). Although there is often reluctance on the part
of both families and clinicians to accept simple reassurance and
counseling, there is no evidence that these episodes are associated with
increased risk of morbidity or mortality. In this setting, undertaking
an extensive workup that may be both intrusive and expensive, has
little justification and may heighten, rather than reduce, anxiety.
Given the lack of proven efficacy for intrusive and expensive management
strategies, families and clinicians should be reassured that the
vast majority of infants with a possible ALTE appear well within
minutes and will have no subsequent significant problems. rnatively,
when findings are suggestive that the event was truly life-threatening,
further evaluation, generally in the hospital, is..."
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