A Journal Article a Week (18/02/11): “Evaluation and management of apparent life-threatening events in infants”

Late again with his one, but then, now I’m caught up. You can sign up for the journal article a week challenge at Rob Fraser’s website Nursing Ideas. And really, what are you waiting for? If you had started with me, you’d have four articles read already!

APA Citation: Scollan-Koliopoulos, M., & Koliopoulos, J. (2010). Evaluation and management of apparent life-threatening events in infants. Pediatric Nursing, 36(2), 77-83. Retrieved from EBSCOhost.

The Skinny: Apparent life- threatening events (ALTEs) are under-reported and probably under-treated in the emergency department setting. This article provides an overview to causes and nursing management with a particular emphasis on care at home after the event.

Money Quotes:

“The hallmark of an ALTE is a parental report of a frightening, sudden display of the symptoms and a quick recovery with or without bystander intervention, such as stimulation or resuscitation.For example, parents may reportneeding to do cardiopulmonary resuscitation on their infant, yet whenthey arrive at the emergency department, a completely normal-appearinginfant is observed by the clinician. Parents may perceive that their reports are not believed by health care providers.”

“The relationship between ALTEs and sudden infant death syndrome (SIDS) is controversial. With less than 7% of patients diagnosed with SIDS having a previous hospital record of an ALTE, it is believed that not all ALTE victims are at risk for SIDS, but that there may be a subpopulation of infants who experience an ALTE who are at risk for SIDS, suggesting thery are not part of the same entity. Like SIDS, ALTEs occur more in the winter months and are associated with second-hand smoke exposure. Infant positioning has been implicated as a contributing factor.”

New Insights: 1. At home monitoring as described (80-81) is exceedingly complicated, even for health care professionals, and may effectively represent a barrier to care to parents.

2. Differentiating between central and obstructive apnea is essential in assessing infants presenting with ALTE, and should be done as part of obtaining the history at triage using CIAMPEDS.*

Why You Should Care: ALTEs can have a significant impact not only on neonates and infants, but also on caregivers who themselves who may suffer from psychological distress from witnessing these events. Nurses and nursing are in a unique position to provide support and counselling.

Next Week: Recognizing neuroleptic malignant syndrome in the emergency department: a case study.

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*CIAMPEDS: a mnemonic for paediatric assessment = Complaint, Immunization, Allergies, Medications, Past History/Pain, Events Surrounding, Diet/Diapers (important for assessing dehydration), Symptoms.

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  1. #1 by Terri Schmitt on Wednesday 23 February 2011 - 1448

    Very good! OH LORD I AM SO BEHIND in this challenge.

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