The diagnosis formerly known as ALTE

The AAP has formally changed the name of ALTE to Brief Unexplained Event (BRUE). The definition has also been formalized with more specific criteria and suggestions to empower the clinician to base the diagnosis on their suspicion rather than relying only on the caregiver’s history.

BRUE is an event occurring in an infant <1 year of age when an observer reports a sudden, brief (<1 min), and now resolved episode of ≥1 of the following without explanation:

  • Cyanosis or pallor
  • Absent, decreased, or irregular breathing
  • Marked change in tone (hyper- or hypotonia)
  • Altered level of responsiveness
  • Must have returned to baseline
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UTox and cross reactivity

Many non illicit drugs cross react with common drugs screened on the traditional urine drug screen.

  • NSAIDs can cause false positive cannabinoid screens
  • Sertraline can cause a benzo false positive
  • Most benzodiazepine screens look for oxazepam which is a metabolite of diazepam and chlordiazepoxide. Therefore, lorazepam, alprazolam, and clonazepam are commonly missed.

What is the detection interval for marijuana on a UDS?Read more