Document Detail


Apparent life-threatening events in infants: high risk in the out-of-hospital environment.
MedLine Citation:
PMID:  15159701     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: The purpose of this study is to define the prevalence and significance of apparent life-threatening events among infants in the out-of-hospital setting. METHODS: This was a retrospective, cohort, outcome study of infants for whom a caregiver activated the emergency medical services (EMS) system. For purposes of the study, an apparent life-threatening event was defined as an episode of apnea, skin color change, or change in muscle tone. Study data characteristics included initial physical appearance, work of breathing, circulation skin signs, pulse rate, respiratory rate, and overall concern for the chief complaint as interpreted by EMS personnel. RESULTS: Sixty (7.5%) of 804 infants encountered by EMS during the study period met our criteria for apparent life-threatening event. Mean age was 3.1+/-3.3 months, and 55% were boys. Of the infants with apparent life-threatening event, 50 (83.3%) infants appeared to be in no distress, 8 (13.3%) infants were in mild distress, and 2 (3.3%) infants were in moderate distress. General physical appearance, work of breathing, circulatory signs, respiratory rate, and pulse rate were not clinically abnormal in the study group as a whole. Critical conditions associated with apparent life-threatening event included pneumonia or bronchiolitis (12%), seizure (8%), sepsis (7%), intracranial hemorrhage (3%), bacterial meningitis (2%), dehydration (2%), and severe anemia (2%). Limitations of the study included retrospective design and inability to follow up study patients beyond hospital discharge. CONCLUSION: An apparent life-threatening event in an infant can present without signs of acute illness and is commonly encountered in the EMS setting. It is often associated with significant medical conditions, and EMS personnel should be aware of the clinical importance of an apparent life-threatening event. Infants meeting criteria for an apparent life-threatening event should receive a timely and thorough medical evaluation.
Authors:
Samuel J Stratton; Adrian Taves; Roger J Lewis; Heidi Clements; Deborah Henderson; Maureen McCollough
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  43     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-25     Completed Date:  2004-10-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  711-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Harbor-University of California-Los Angeles Medical Center, Torrance, CA, USA. strattos@uci.edu
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MeSH Terms
Descriptor/Qualifier:
Anemia / physiopathology
Apnea*
Cohort Studies
Cyanosis*
Dehydration / physiopathology
Emergencies*
Emergency Medical Services
Female
Heart Rate
Humans
Infant
Intracranial Hemorrhages / physiopathology
Male
Meningitis, Bacterial / physiopathology
Muscle Hypotonia*
Muscle Rigidity*
Respiration
Respiratory Tract Infections / physiopathology
Retrospective Studies
Risk
Seizures / physiopathology
Sepsis / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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