PT  - JOURNAL ARTICLE
AU  - F Davies
AU  - R Gupta
TI  - Apparent life threatening events in infants presenting to an emergency department
AID  - 10.1136/emj.19.1.11
DP  - 2002 Jan 01
TA  - Emergency Medicine Journal
PG  - 11--16
VI  - 19
IP  - 1
4099  - http://emj.bmj.com/content/19/1/11.short
4100  - http://emj.bmj.com/content/19/1/11.full
SO  - Emerg Med J2002 Jan 01; 19
AB  - Objective: To describe the aetiology and outcome of apparent life threatening events (ALTE) presenting to an emergency department (ED), and to assess the value of an initial investigation protocol. Design: A 12 month prospective study of infants under 1 year of age who presented to a children's hospital ED after an ALTE. A standardised history sheet and initial investigation protocol were used. All infants were admitted to hospital and followed up at six months. Results: There were 65 infants recruited, median age 7 weeks. None had died at the time of writing. Diagnoses included gastro-oesophageal reflux n=17 (26%), pertussis, n=6 (9%), seizures, n=6 (9%), urinary tract infection (5), factitious illness (2), brain tumour, atrial tachycardia, persistent ductus arteriosus and opioid related apnoea. No diagnosis was reached in 15 cases (23%). Fifty seven (88%) had only one admission to hospital for ALTE. More serious diagnoses were associated with a presentation age over 2 months, abnormal initial clinical examination, and recurrent ALTE. Conclusions: ALTEs presenting to the ED may remain as a single, unexplained event or be attributable to numerous causes, ranging from minor to serious. Knowledge of the commoner causes and factors associated with higher risk could result in a more targeted approach, improving the decision making process and benefiting both infants and parents.