Patient selection: BRUE episode
An infant is considered to be at lower risk if all of the following are present:
(1) age > 60 days
(2) gestational age >= 32 weeks and postconceptional age >= 45 weeks
(3) no previous BRUE ever and not occurring in clusters (first BRUE)
(4) duration of the event was less than 1 minute
(5) no CPR was required by trained medical provider
(6) no concerning historical features (family or social history, feeding or respiratory problems)
(7) no concerning findings on physical examination
An infant who is not lower risk is considered as having higher risk.
A patient with lower risk BRUE:
(1) should not have extensive testing
(2) should not be admitted for monitoring
(3) can have a 12-lead ECG and pertussis testing
(4) can be briefly monitored with serial observations and with a pulse oximeter
Caregivers should be educated about BRUE and offered training in CPR. There should be shared decision-making on evaluation and follow-up.
