👶 BRUE Criteria (Brief Resolved Unexplained Event)
UseWhen to use: brief resolved unexplained events formerly called ALTE.
StrataLow-risk may allow limited ED evaluation; higher-risk needs broader workup/admission.
LimitsWhen not to use: ongoing illness or explained events (label the diagn… · Pitfall: calling BRUE when the infant is still symptomatic. · Consider NAT, arrhythmia, infection when higher-risk.
SourceTieder JS et al. Pediatrics 2016 (AAP BRUE)
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Definition first.
When to use
When to use: brief resolved unexplained events formerly called ALTE.
How it works
Definition checklist + low-risk bundle (age, gestation, first event, no CPR, Hx/exam).
Key points
- Definition first.
- Low-risk is strict.
- Next: AAP BRUE pathway / pediatrics admit.
References
- [Guideline / primary source]Tieder JS et al. Pediatrics 2016 (AAP BRUE)
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Infant age < 1 year | No |
|---|---|
| Event was brief (<1 minute; typically <20–30 s) | No |
| Now resolved / back to baseline | No |
| ≥1 feature: cyanosis or pallor; absent/decreased/irregular breathing; marked change in tone; altered responsiveness | No |
| Unexplained after appropriate history and physical (no explanation such as GER reflux witnessed, nasal obstruction, etc.) | Explained / alternative diagnosis |
| Low-risk age: >60 days | No (≤60 d) |
| Low-risk gestation: ≥32 weeks AND postconceptional age ≥45 weeks | No |
| Low-risk: first BRUE (no prior BRUE / no cluster) | No — prior or cluster |
| Low-risk: no CPR by trained medical provider | CPR was given by trained provider |
| Low-risk: no concerning historical features (e.g. unexplained death of sibling, possible child abuse, family history concerning for arrhythmia) | Concerning history present |
| Low-risk: no concerning physical exam findings | Concerning exam |
→BRUEDoes not meet BRUE definition
- Next：Manage the explained diagnosis or ongoing illness; BRUE pathway N/A
| Infant age < 1 year | Yes |
|---|---|
| Event was brief (<1 minute; typically <20–30 s) | Yes |
| Now resolved / back to baseline | Yes |
| ≥1 feature: cyanosis or pallor; absent/decreased/irregular breathing; marked change in tone; altered responsiveness | Yes |
| Unexplained after appropriate history and physical (no explanation such as GER reflux witnessed, nasal obstruction, etc.) | Unexplained — meets BRUE definition pathway |
| Low-risk age: >60 days | Yes (>60 d) |
| Low-risk gestation: ≥32 weeks AND postconceptional age ≥45 weeks | Yes |
| Low-risk: first BRUE (no prior BRUE / no cluster) | Yes — first |
| Low-risk: no CPR by trained medical provider | No CPR by trained provider |
| Low-risk: no concerning historical features (e.g. unexplained death of sibling, possible child abuse, family history concerning for arrhythmia) | No concerning history |
| Low-risk: no concerning physical exam findings | Exam reassuring |
→BRUELow-risk BRUE
- Definition：Met
- Risk tier：Low-risk per AAP 2016
Verification & sources · governance
FAQ
Frequently asked questions
- Does BRUE Criteria (Brief Resolved Unexplained Event) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is BRUE Criteria (Brief Resolved Unexplained Event) calculated in practice? Can you show a worked example?
- Inputs: Infant age < 1 year No, Event was brief (<1 minute; typically <20–30 s) No, Now resolved / back to baseline No, ≥1 feature: cyanosis or pallor; absent/decreased/irregular breathing; marked change in tone; altered responsiveness No, Unexplained after appropriate history and physical (no explanation such as GER reflux witnessed, nasal obstruction, etc.) Explained / alternative diagnosis, Low-risk age: >60 days No (≤60 d), Low-risk gestation: ≥32 weeks AND postconceptional age ≥45 weeks No, Low-risk: first BRUE (no prior BRUE / no cluster) No — prior or cluster… → Result: BRUE Does not meet BRUE definition（Next: Manage the explained diagnosis or ongoing illness; BRUE pathway N/A） Inputs: Infant age < 1 year Yes, Event was brief (<1 minute; typically <20–30 s) Yes, Now resolved / back to baseline Yes, ≥1 feature: cyanosis or pallor; absent/decreased/irregular breathing; marked change in tone; altered responsiveness Yes, Unexplained after appropriate history and physical (no explanation such as GER reflux witnessed, nasal obstruction, etc.) Unexplained — meets BRUE definition pathway, Low-risk age: >60 days Yes (>60 d), Low-risk gestation: ≥32 weeks AND postconceptional age ≥45 weeks Yes, Low-risk: first BRUE (no prior BRUE / no cluster) Yes — first… → Result: BRUE Low-risk BRUE（Definition: Met, Risk tier: Low-risk per AAP 2016）