RT Book, Section A1 Rhine, Jonathan A1 Sapien, Robert A1 Tieder, Joel S. A2 Tenenbein, Milton A2 Macias, Charles G. A2 Sharieff, Ghazala Q. A2 Yamamoto, Loren G. A2 Schafermeyer, Robert SR Print(0) ID 1155167348 T1 Brief Resolved Unexplained Events T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259860751 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1155167348 RD 2024/03/28 AB A brief resolved unexplained event (BRUE) is defined as “an event occurring in an infant younger than 1 year when the observer reports a sudden, brief, and now resolved episode of ≥1 of the following: (1) cyanosis or pallor; (2) absent, decreased, or irregular breathing; (3) marked change in tone (hyper- or hypotonia); and (4) altered level of responsiveness,” and a thorough history and physical examination which fails to identify an explanation.1,2BRUE is a more specific term intended to replace ALTE (apparent life-threatening event)BRUE is cohorted into lower- and higher-risk groups. Criteria for lower-risk include (1) age >60 days, (2) gestational age ≥32 weeks and postconceptional age ≥45 weeks, (3) a single episode with no previous BRUEs, (4) duration of BRUE <1 minute, (5) no cardiopulmonary resuscitation by trained medical personnel required, (6) no concerning historical features, and (7) no concerning physical examination findings.Lower-risk BRUE infants generally do not require clinical investigations and can be discharged home from the emergency department (ED).Most higher-risk patients, particularly those under 2 months of age, typically benefit from hospitalization for further monitoring for recurrent events, diagnostic evaluation, or treatment. In some cases, close outpatient follow-up may be reasonable.BRUE is a diagnosis of exclusion just like another acute idiopathic condition of infancy, the febrile seizure. Both have lower- and higher-risk categories. The lower-risk groups of both of these conditions require few if any investigations and can be discharged from the ED.