12/31/2023 0 Comments Vchat aapThis clinical practice guideline also provides implementation support and suggests directions for future research. It does not offer recommendations for higher-risk patients whose history and physical examination suggest the need for further investigation and treatment (because of insufficient evidence or the availability of clinical practice guidelines specific to their presentation). Third, it provides evidence-based management recommendations, or key action statements, for lower-risk patients whose history and physical examination are normal. Second, it provides an approach to patient evaluation that is based on the risk that the infant will have a recurring event or has a serious underlying disorder. First, it recommends the replacement of the term apparent life-threatening event (ALTE) with a new term, brief resolved unexplained event (BRUE). This clinical practice guideline applies to infants younger than 1 year and is intended for pediatric clinicians. Each key action statement indicates a level of evidence, the benefit-harm relationship, and the strength of recommendation. This clinical practice guideline is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient outcomes, support implementation, and provide direction for future research. By using this definition and framework, infants younger than 1 year who present with a BRUE are categorized either as (1) a lower-risk patient on the basis of history and physical examination for whom evidence-based recommendations for evaluation and management are offered or (2) a higher-risk patient whose history and physical examination suggest the need for further investigation and treatment but for whom recommendations are not offered. A BRUE is diagnosed only when there is no explanation for a qualifying event after conducting an appropriate history and physical examination. The term BRUE is defined as an event occurring in an infant younger than 1 year when the observer reports a sudden, brief, and now resolved episode of ≥1 of the following: (1) cyanosis or pallor (2) absent, decreased, or irregular breathing (3) marked change in tone (hyper- or hypotonia) and (4) altered level of responsiveness. Finally, it provides management recommendations, or key action statements, for lower-risk infants. Second, it provides an approach to patient evaluation that is based on the risk that the infant will have a repeat event or has a serious underlying disorder. First, it recommends the replacement of the term ALTE with a new term, brief resolved unexplained event (BRUE). This clinical practice guideline has 3 objectives. This is the first clinical practice guideline from the American Academy of Pediatrics that specifically applies to patients who have experienced an apparent life-threatening event (ALTE).
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