Brief Resolved Unexplained Event BRUE (ALTE guideline update), Paediatrics

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This guideline has been developed for the evaluation, risk stratification, investigation and management of patients presenting to hospital with a brief resolved unexplained event (BRUE). This guideline is intended to replace the previous guidance on Apparent life-threatening events (ALTE), due to updated evidence and reclassification of such presentations. 

An ALTE is a descriptive term based on an event that is frightening to the observer including a combination of: apnoea, colour change, change in muscle tone, choking or gagging. This definition includes both physiological and pathological causes for events. 

It has been recommended that the term ALTE is replaced with the new term “Brief Resolved Unexplained Event” or BRUE. This concept differs from an ALTE both in definition, and in allowing risk stratification of patients, which in turn can guide further management. 

BRUE allows for health care professional to categorise event, and stratify infants as lower or higher risk of having a repeated episode or a serious underlying disorder. Higher risk patients require further investigation +/- treatment.

NOTE: this guideline is hosted on the NHSGGC Paediatrics Guidelines website. Clicking on the link below will open the guideline in a new window.


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