What to Do when Babies Turn Blue: Beyond the Basic Brief Resolved Unexplained Event

Emerg Med Clin North Am. 2018 May;36(2):335-347. doi: 10.1016/j.emc.2017.12.001. Epub 2018 Feb 10.


The term "brief resolved unexplained event" was created to replace "apparent life-threatening event," narrowing the definition and providing evidence-based guidelines for management. The emphasis is placed on using clinical clues to classify patients as low risk or exclude them from the categorization altogether. Infants who meet low-risk classification can be briefly observed in the emergency department and be discharged home. Infants who demonstrate elements suggestive of a specific etiology should be evaluated and treated accordingly. Patients who demonstrate no specific findings yet who are high risk should be evaluated for the most common etiologies of apneic events and be admitted.

Keywords: Apnea; Apparent life-threatening event (ALTE); Brief resolved unexplained event (BRUE); Gastroesophageal reflux (GER); Nonaccidental trauma; Pertussis; Respiratory syncytial virus (RSV).

Publication types

  • Review

MeSH terms

  • Apnea / diagnosis*
  • Cyanosis / diagnosis*
  • Humans
  • Infant
  • Infant, Newborn
  • Muscle Hypotonia / diagnosis*
  • Pediatric Emergency Medicine*
  • Risk Assessment / methods*
  • Somatoform Disorders / diagnosis*