Podcast #389: BRUE - The Emergency Medical Minute

Educational Pearls:


  • BRUE (Brief Resolved Unexplained Event) replaces what was previously called ALTE
  • BRUE describes an event in a child less than one year of age with one or more of the following:
    • cyanosis or pallor
    • absent, decreased, or irregular breathing
    • decreased or increased tone
    • altered responsiveness
  • These must be sudden, brief, and now resolved and without an alternative explanation after a history and physical exam
  • Low risk patients can be safely discharged with reassurance
  • Low risk criteria must all be present:
    • Age over 60 days old
    • >32 weeks gestational age at birth and adjusted gestational age > 45 weeks)
    • No CPR was performed (by a trained medical professional)
    • First event
    • Duration less than 1 minute of event
  • Patients who satisfy above criteria can be considered low risk and may be discharged after minimal/no workup



Tieder JS, Bonkowsky JL, Etzel RA, et al. Clinical Practice Guideline: Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants: Executive Summary. Pediatrics. 2016:137(5):e20160591. Pediatrics. 2016 Aug;138(2). pii: e20161488. doi: 10.1542/peds.2016-1488. PubMed PMID: 27474017.


Summary by Travis Barlock, MS4    |   Edited by Erik Verzemnieks, MD

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