Emergency medicine updates: Pediatric brief resolved unexplained event.

INTRODUCTION

Brief resolved unexplained events (BRUEs) can occur in a large number of pediatric patients, with most having a benign etiology. However, in many cases, these can result in unnecessary evaluations and admissions among low-risk patients. Therefore, it is critical for clinicians to be aware of the current evidence regarding BRUE in the emergency department (ED) setting.

OBJECTIVE

This paper evaluates key evidence-based updates concerning pediatric BRUE for the emergency clinician.

DISCUSSION: A BRUE is defined as a clinical entity occurring in an infant less than 1 year of age that an observer reports as sudden, brief (< 1 min), and now resolved episode with no explanation and accompanied by at least one of the following: Change in breathing, pallor or cyanosis, change in tone, or altered level of consciousness. BRUEs often cause significant distress for both caregivers and medical professionals. Having an approach to risk-stratification and engaging in shared decision-making with caregivers can help guide clinicians during these encounters. Clearly identifying what qualifies as a low-risk event can minimize unnecessary testing while ensuring that children who do not meet low-risk criteria receive an appropriately focused evaluation

CONCLUSION

An understanding of the current literature concerning BRUE can assist emergency clinicians and improve the care of these patients.