• Apparent Life-Threatening Event

    (ALTE)

    Definition

    An apparent life-threatening event (ALTE) is a set of symptoms in an infant that cause the caregiver to believe the child may be dying or has died. It may include disturbed breathing, change in color, choking or gagging. Cardiopulmonary resuscitation (CPR) may be needed at the time of the event.

    Causes

    The cause of ALTE is not always clear. Some likely causes of ALTE may include:
    • Digestive problems, such as gastroesophageal reflux disease
    • Neurological problems, such as a seizure disorder or problems with the breathing center in the brain
    • Respiratory problems, such as lung infection or something blocking the airway
    • Infections
    • Heart problems, such as an abnormal heartbeat
    • Problems with the endocrine system, which includes the glands and hormones
    • Metabolic problems, such as hypoglycemia
    • Child abuse

    Risk Factors

    Boys and babies younger than one year of age are at higher risk of ALTE. Other factors that may increase an infant’s risk of ALTE include:

    Symptoms

    Symptoms may include:
    • Breathing that stops
    • Changes in skin color—blue, red, or pale
    • Change in muscle tone—floppy or tense
    • Choking
    • Gagging

    Diagnosis

    The doctor will ask about your baby’s symptoms and medical history, including what you noticed in the time leading up to the ALTE. A physical and neurological exam will be done.
    To look for potential causes of ALTE the doctor may order:
    • Blood and urine tests may be done to look for infections or other problems in the body’s fluids.
    • X-rays and ultrasounds may also be done to take images of your baby’s bodily structures.
    Other tests may include:

    Treatment

    Talk with your doctor about the best treatment plan for your baby. Options include life-saving treatment if needed and treating the underlying cause of the ALTE. If the cause is unknown, treatment involves monitoring the child for symptoms.

    Life-saving Treatment

    CPR is a life-saving treatment that can be delivered by non-medical and medical people. It may restore breathing and blood circulation or help provide oxygen to the body until medical help arrives.
    Consider taking a class in infant CPR so you are prepared.

    Treating the Underlying Cause

    If a cause is found, then the underlying condition will be treated.

    Monitoring

    In half of the babies who have an ALTE, the cause is not known. Home monitoring may be needed if advised by your baby’s doctor. A monitor can record your baby’s heart and breathing activity. An alert will sound if your baby is having another event.

    Prevention

    There is no known way to prevent an ALTE.

    RESOURCES

    American Academy of Family Physicians http://familydoctor.org

    American Academy of Pediatricians http://www.healthychildren.org

    CANADIAN RESOURCES

    Canadian Paediatric Society http://www.cps.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    ALTE—Apparent life-threatening event. Auckland District Health Board website. Available at: http://www.adhb.govt.nz/starshipclinicalguidelines/ALTE%20Apparent%20Life%20Threatening%20Event.htm. Updated April 2012. Accessed November 1, 2013.

    Apparent life-threatening event. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 19, 2013. Accessed November 1, 2013.

    Apparent life threatening event ALTE. The Royal Children’s Hospital Melbourne website. Available at: http://www.rch.org.au/clinicalguide/guideline%5Findex/Apparent%5FLife%5FThreatening%5FEvent%5FALTE/. Accessed November 1, 2013.

    Clinical practice guideline: apparent life threatening event (ALTE). Prince Margaret Hospital website. Available at: http://www.pmh.health.wa.gov.au/development/manuals/clinical%5Fpractice%5Fguidelines/documents/alte%5Fcpg.pdf. Updated January 2009. Accessed November 1, 2013.

    Hall K, Zalman B. Evaluation and management of apparent life-threatening events in children. AM Fam Physician. 2005 June 15;71(12):2301-2308.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.