Apparently Life-Threatening Event (Alte)

An apparently life-threatening event (apparent life-threatening event) is the sudden onset of certain alarming symptoms (eg. B. apnea, change in color or muscle tone, coughing, choking, smothering). The caregiver may fear that the child dead or his life is threatened. It usually occurs in children <1 year with the highest frequency at 10-12 weeks. Causes can in the digestive system, the respiratory tract, to be found in the metabolism of infectious diseases in the nervous system, heart or. Traumatic causes (eg. As abuse) are possible. The treatment depends on the specific identified cause.

An apparently life-threatening event (ALTE) is not a diagnosis, but a group of symptoms that occur acutely in young children.

An apparently life-threatening event (apparent life-threatening event) is the sudden onset of certain alarming symptoms (eg. B. apnea, change in color or muscle tone, coughing, choking, smothering). The caregiver may fear that the child dead or his life is threatened. It usually occurs in children <1 year with the highest frequency at 10-12 weeks. Causes can in the digestive system, the respiratory tract, to be found in the metabolism of infectious diseases in the nervous system, heart or. Traumatic causes (eg. As abuse) are possible. The treatment depends on the specific identified cause. An apparently life-threatening event (ALTE) is not a diagnosis, but a group of symptoms that occur acutely in young children. Etiology The most common causes are: digestive system: Gastroesophageal reflux disease or swallowing, if they are connected with laryngospasm or aspiration Nervous System: Neurological disorders such. B. seizures, brain tumors, breath holding or abnormal brain stem neuroregulation of the cardiorespiratory control, hydrocephalus, brain malformations airways: infections, z. B. Respiratory syncytial virus, influenza, whooping cough infectious diseases: sepsis, meningitis Less common causes include heart disease metabolic disorders obstruction of the upper respiratory tract (eg, obstructive sleep apnea.) Other (eg medications, anaphylaxis, child abuse.) The causes can primarily be (genetic) or secondary. Approximately 10% of cases are considered idiopathic. If a child repeated under the care of a person episodes without clear etiology has child abuse should be considered. Symptoms and signs A OLD is generally characterized by an unexpected, acute change in the breathing of the child, who alerted the parents or caregiver. Among the features of such an event some or all of the following may include: apnea episode color change, change in muscle tone choking or gagging Many children seem to be doing better at the time of the medical examination. Persistent symptoms are worrying, but they can help find the cause. Diagnosis A clarification begins with a thorough medical history, including observations of the caregiver who has witnessed the event, in particular a description of the changes in breathing, color, muscle tone and eyes and the sounds uttered, the duration of the episode and the previous signs such as shortness of breath or hypotension action taken (eg. as gentle stimulation, mouth-to-mouth resuscitation and cardiopulmonary resuscitation, CPR) Prenatal (mother's side) and current home treatment with drugs, tobacco and alcohol information about the birth of the child (eg B. gestational age., perinatal complications) eating habits such. As if choking, coughing, vomiting, or poor weight gain occurred child development (eg. As milestones) Background to the OLD or recent trauma family history of ALTE, premature deaths, diseases or possible causal disorders A physical examination is performed to obvious malformations to detect neurological abnormalities (eg. as entertainment, inappropriate head position) and signs of infection or trauma (mainly including retinal bleeding by fundoscopy). Laboratory and imaging tests (s. Diagnostic tests for causes of an apparently life-threatening event (ALTE)) are carried out to check possible causes. These tests are arranged because of the findings in history and physical examination. Investigations are made of it also as a function of whether the child is still symptomatic or required medical intervention. Risk factors for child abuse should be assessed with caution (child abuse at a glance). Recurring OLD speak for abuse when they occur only in the presence of a parent or caregiver, but not in the care of hospital staff or when the child is alone (z. B. sleeping, while it is connected to a monitor). Diagnostic tests for causes of an apparently life-threatening event (ALTE) tests Possible causes Typical initial test blood tests usually include the following: blood count with differential diagnosis electrolytes (Mg, Ca, Na, K), bicarbonate and glucose liver lactate acidosis anemia dehydration infectious liver diseases metabolic disorders radiograph chest echocardiography Cardiomegaly infection cultures (blood, stool, urine, cerebrospinal fluid) infection electrocardiogram (ECG) Cardiac monitoring in hospital arrhythmias QT abnormalities lumbar puncture meningitis skeletal system fractures Toxicological screening overdose Urinalysis infection Additional tests on the basis of clinical suspicion blood gas examination acidosis Imaging methods of the head (computed tomography, magnetic resonance imaging) trauma, bleeding, tumor EEG seizures Esophageal pH Monitoring * Gastroesophageal Reflux Disease Nasal swab respiratory syncytial virus infection pertussis blood tests and cultures pertussis serum lactate hereditary enzyme defects (eg. As glycogen storage disease type I, impaired fatty acid oxidation, multiple carboxylase deficiency, methylmalonic) hypoxia toxins (z. B. salicylates, ethylene, glycol, ethanol, methanol) scanning the upper digestive tract with radioisotopic milk * Gastroesophageal Reflux Disease * In infants with a history of spitting, choking, vomiting, cough, or food refusal. Clinical calculator: QT interval correction (ECG) Prognosis The prognosis depends on the cause of the ALTE. For example, the life risk is higher if the cause is a severe neurological disorder. The relationship of the OLD for SIDS SIDS (Sudden Infant Death Syndrome (SIDS)) is unclear. About 4-10% of children who die of SIDS have any history of OLD, and the risk of SIDS is higher when a child has had 2 or more OLD. Also have children who have an OLD, characteristics similar to babies who die from SIDS. However, the incidence of OLD is in contrast to the left of SIDS after Safe to Sleep® campaign unchanged. There seems to be no long-term impact on the development by the OLD to give itself, but the causative disease (z. B. cardiac or neurological) may have such effects. Treatment Treating the cause Sometimes domestic monitors The cause is treated when it has been identified. If the infant requires resuscitation or when the examination detects abnormalities, the infant is admitted to the hospital for evaluation. There the airways and the heart are monitored with monitors and performed some of the tests Diagnostic tests for causes of an apparently life-threatening event (ALTE) listed. Parents and caregivers should receive training for cardiopulmonary respiration (CPR) in infants and for safe infant care. Monitoring devices for the home can be considered for a relapse into consideration in infants with the following high risk factors: A OLD, the CPR required prematurity A sibling who died of SIDS Monitors should be equipped with data storage and used for a predetermined period of time. Parents should learn how to use the monitor and be noted that the home monitor surveillance to is not able to reduce the mortality. In addition, exposure to tobacco smoke must be eliminated. Summary OLD have many possible causes, and in many cases no etiology is identified. Respiratory, neurological, infectious, cardiac, metabolic and gastrointestinal diseases, and abuse should be considered, where the testing is performed based on the clinical findings. The prognosis depends on the cause. The risk of death is increased in children with a neurological disease, and in children with two or more OLD, as in children who had a nichtakzidentielles trauma or who are older than 6 months old and have an OLD of longer duration and especially if they have heart disease. Children with abnormal examination findings or laboratory results or children who require medical intervention or who have a worrying history, be hospitalized. Treatment is directed at the cause; Monitor home monitoring may be appropriate, but has so far not reduce mortality.

Health Life Media Team

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