Infant BRUE (Brief Resolved Unexplained Event): Sudden Color Change, Limpness, or Apnea¶

Watching a baby under 1 year of age suddenly stop breathing, turn blue or ghostly pale, go limp like a ragdoll or stiffly arch their back, and then recover within seconds is one of the most terrifying events a parent or caregiver can witness. In pediatric emergency medicine, when an infant under 12 months experiences a sudden episode lasting less than 1 minute involving cyanosis or pallor, absent or irregular breathing, marked change in muscle tone, or altered responsiveness that completely resolves back to baseline without an obvious cause, clinicians classify it as a Brief Resolved Unexplained Event (BRUE). Hali ni den bɛ i ko a kɔrɔtɔlen don kɛmɛsarada la, a ɲɛ ye bulama ye, ani a nisɔndiyalen don i ka telefɔni ta waati la, denyɛrɛni min si tɛ san 1 bɔ, o ko bɛɛ ɲɛfɔbali bɛ a ɲini dɔgɔtɔrɔso la joona ni i ye i ka sigida wele kɔrɔtɔko nimɔrɔw (911 Ameriki ani Kanada, 112 Erɔpu tɔnba bɛɛ kɔnɔ, 999 Angletɛri) walima ka taa ɲɛfɛ denmisɛnw ka kɛnɛyaso kɔrɔtɔlen dɔ la. Fɛn min bɛ i n’a fɔ segin 20 lafiɲɛbɔ min tɛ kojugu ye, o bɛ se ka kɛ lasɔmini taamasiɲɛ fɔlɔ ye min bɛ sɔrɔ sɔgɔsɔgɔninjɛ (sɔgɔsɔgɔninjɛ), ninakilidegun banakisɛ (RSV), dusukun tantanni gɛlɛya i n’a fɔ Long QT Syndrome, farikolojidɛsɛ bangenen, walima laryngospasm, ani aw ka kan ka a kɛcogo fana dɔn pediatric and infant CPR and choking denmisɛnnin dɔ kisi ani k’a faranfasi BRUE ka bɔ denmisɛnnin na breath-holding spells and infant apnea walima denmisɛnniw ka fariganba ni farigan jugumanba.

Aw bɛ o kɛ sisan¶

1. Aw bɛ den bila u kɛrɛ fɛ yɔrɔ jɛlen na ka fiɲɛbɔyɔrɔ ni ninakilicogo lajɛ joona. Aw kana den min bɛ senna walima min tɛ jaabi di, o minɛ ka jɔ aw kamankun kan, barisa ni aw jɔlen don, o bɛ joli bɔ a kunkolo la ani ka a to kunkolo floppy ka jigin ka bɔ a dawolo la ka taa a disi la, ka fiɲɛbɔlan nɔgɔlen da tugu. Aw bɛ den da u kɛrɛ fɛ (denmisɛnninw ka kɛnɛya yɔrɔ) matirili gɛlɛn kan, duguma, walima fɛn caman cili tabali kan walasa nɔnɔ walima nɔgɔ min bɛ segin kɔ, o ka bɔ da la sanni ka don fogonfogon la.
2. Apply firm tactile stimulation for 5 to 10 seconds (never shake the baby). Briskly rub the baby's back or breastbone (sternum), flick or tap the soles of their bare feet, and blow a gentle puff of cool air across their cheek to trigger the trigeminal respiratory reflex. Never shake an infant back and forth to wake them up, as shaking tears delicate bridging veins inside the skull and causes lethal brain hemorrhage.
3. Start infant CPR or choking rescue immediately if the baby does not breathe or respond within 10 seconds. Put your phone on speaker to call your local emergency number (911 in the United States and Canada, 112 across the European Union, 999 in the United Kingdom). If the baby is silent and unable to breathe right after feeding or gagging on thick liquid, deliver 5 infant back blows (supporting the jaw and chest along your forearm with the head lower than the rump) followed by 5 two-finger chest thrusts; if the baby is unresponsive with no normal breathing and no obvious choking blockage, begin Infant CPR at 30 chest compressions to 2 gentle puffs of air (or 15:2 if two trained rescuers are present), pressing 4 centimeters (1.5 inches) deep in the center of the chest just below the nipple line at a rate of 100 to 120 compressions per minute.
4. Look at your watch or phone clock and note the exact duration and four clinical details. Doctors in the emergency room rely on your eyewitness observation to classify the baby as Low-Risk or High-Risk BRUE. Mentally lock in or write down: (a) how many seconds the event lasted, (b) the exact color of the lips, tongue, and face (blue/purple, ghostly white/gray, or bright red), © whether the baby's body went completely floppy (hypotonia) or rigid and arched (hypertonia), and (d) what the baby was doing in the 5 minutes before the event (sleeping flat, sitting in a car seat, feeding, spitting up, or crying).
5. Go to an emergency department immediately even if the baby looks 100 percent normal now. Do not put the baby back down to sleep at home and wait for a morning pediatrician appointment. In infants under 12 months (and especially infants under 60 days of age or born prematurely before 32 weeks gestation), a resolved 30-second apneic pause is frequently the sentinel event preceding a second, longer, life-threatening cardiorespiratory arrest hours later during deep sleep.
6. Photograph the exact sleep or feeding environment and bring the baby's formula, medications, and caregiver list to the hospital. Before leaving or while another adult packs, snap a quick smartphone photo of where the baby was lying (crib, bassinet, inclined sleeper, car seat, or adult bed) and bring any open formula cans, vitamin drops, herbal teething gels, or household cold medicines so emergency physicians can perform a complete safe-sleep and toxicology audit.

Decision tree: Infant sudden color change, breathing pause, or limpness¶

flowchart TD
    A["Infant under 12 months suddenly stops breathing, turns blue/pale, or goes limp/stiff"] --> B{"Lay flat on side + rub sternum / flick soles for 5 to 10 sec. Does breathing return?"}
    B -->|"No: Unresponsive and not breathing normally"| C["Call 911 / 112 / 999 on speaker immediately"]
    C --> D{"Did episode start with acute choking/gagging on milk or object?"}
    D -->|"Yes: Airway blocked"| E["Perform 5 Infant Back Blows + 5 Chest Thrusts; repeat until airway clears or start CPR if unresponsive"]
    D -->|"No: Central pause or limpness"| F["Start Infant CPR: 30 chest compressions (4 cm / 1.5 in deep, 100 to 120/min) + 2 gentle breaths"]
    B -->|"Yes: Baby recovers within 60 sec and returns to normal baseline"| G{"Does the baby have an obvious active symptom right now? (Fever, wheezing, repetitive vomiting, stridor, lethargy)"}
    G -->|"Yes: Not unexplained"| H["Immediate Emergency Department evaluation for active illness (Sepsis, RSV, Pertussis, Aspiration, Seizure)"]
    G -->|"No: Baby looks 100% normal at baseline (Possible BRUE)"| I{"Check AAP High-Risk BRUE Criteria (Any 1 present?)"}
    I -->|"Age <= 60 days OR Premature < 32 wks (< 45 wks corrected) OR Duration >= 1 min OR Repeat events OR Needed CPR"| J["HIGH-RISK BRUE: Immediate Emergency Department transport + Inpatient admission + Continuous oximetry, Pertussis/RSV PCR, 12-lead ECG, Sepsis/Metabolic screen"]
    I -->|"Age > 60 days to 12 mos AND Full-term >= 32 wks AND First event < 1 min AND No CPR needed AND Normal exam"| K["LOW-RISK BRUE: Urgent Emergency Department evaluation + 1 to 4 hr continuous pulse oximetry, 12-lead ECG, Pertussis test, Safe-Sleep Audit, and 24-hr pediatrician follow-up"]

Clinical criteria: What defines a BRUE and why it replaced ALTE¶

For three decades prior to 2016, pediatricians used the broad umbrella acronym ALTE (Apparent Life-Threatening Event) walasa ka siranfɛn o ko kɛlen ɲɛfɔ denmisɛnnin dɔ la min ye ladonbaga bila ka siran den ɲɛ. O kɔfɛ, dɔgɔtɔrɔso ɲininiw y’o jira ALTE was dangerously imprecise: it lumped together babies who were still actively sick in the emergency room with babies who had completely recovered, and it relied on the subjective degree of caregiver fright rather than objective physiological markers. In 2016 (and reinforced in subsequent international pediatric guidelines), the American Academy of Pediatrics (AAP) ye lafiɲɛbɔ kɛ waati in na ALTE ani ka ** sɛgɛsɛgɛli gɛlɛn, kuntilenna sigilen sigi senkan .BRUE (Ko surun min ɲɛnabɔra min ma ɲɛfɔ)**.

BRUE sɛgɛsɛgɛli jɔnjɔn 4 wajibiyalenw¶

Dɔgɔtɔrɔ bɛna denmisɛnnin dɔ ka bana in jate ** .BRUE** dɔrɔn ni den min si ma se kalo 12 (san 1) ma ani ni o yɔrɔ in bɛ nin sɛgɛsɛgɛli jɔnjɔn ninnu naani bɛɛ wasa:

1. Kurukuruni (A kuntaala bɛ se segin 60 ma): A kɛcogo min tɛ cogo la, o bɛɛ kɛra miniti 1 tɛmɛnen kɔnɔ (a fanba ye tiɲɛ ye BRUE a yɔrɔw bɛ sekɔndi 10 ni 45 cɛ). Ni o yɔrɔ in kɛra miniti 1 (seginkanni 60) ye walima ka tɛmɛ o kan**, o bɛ tɛmɛ a dancɛ surun kan, wa a bɛ kɛ a yɛrɛma ka don Faraba sɛgɛsɛgɛli sira la.
2. A ɲɛnabɔra (kɛmɛsarada la 100 bɛ segin a daminɛ na): Ni den sera dɔgɔtɔrɔso la waati min na, den seginna a cogo kɔrɔ la pewu. U dusukun tantanni, u ninakilidege, oksizɛni caya, u funteni, u farikolojidɛsɛ, u farikolojidɛsɛ, ani u ɲɛda lajɛ ka kan ka kɛ cogo la pewu. Ni den tora sunɔgɔ la, ni sɛgɛn bɛ a la, ni a bɛ ninakili joona (a bɛ ninakili joona), ni farigan bɛ a la, walima ni a bɛ dimi, o ko in tɛ a ɲɛnabɔlen don BRUE, o ye furakɛli kɔrɔtɔko ye min bɛ baara kɛ, min bɛ mɔgɔ lakunu joona ani ka baara kɛ ni laɲini ye.
3. A bɛ danfara don ni laɲini kɛrɛnkɛrɛnnen caman yeli ye 1 la dɔgɔmannin:
4. Central cyanosis or pallor: Bulu jɛlen, bulama, dibi dibi, walima jinɛ finman/ciyɛn kulɛri caman cili min bɛ tali kɛ dawolo, kan, ɲinw, ɲɛda, walima cɛmancɛ jiri la. (Bolo ni senw bulu minnu tɛ kojugu kɛ ni u nɛnɛna, o bɛ wele ko acrocyanose, walima da lamini bilenni waati dɔɔni ka kasi walima ka banakɔtaa tɛmɛ, o tɛ se ka kɛ a BRUE).
5. Ni ninakili tɛ yen, a dɔgɔyara, walima a tɛ kɛ tuma bɛɛ: Ninakili jɔli lakika (apnea), fiɲɛ samali min man dun, walima fiɲɛ bilali barikama/kɛlɛli. (Denmisɛnnin kuraw cogoya bɛnnen ninakili waati ni waati, den sunɔgɔlen bɛ ninakili teliya caman kɛ ka sɔrɔ ka lafiɲɛbɔ segin 5 fo 10 k’a sɔrɔ a tora pinɛ pewu, o ye farikoloɲɛnajɛ ye min bɛ kɛ cogo la, wa a tɛ a BRUE).
6. Yɛlɛma taamasiɲɛ bɛ farikolo yɔrɔw la (hypotonia walima hypertonia): Denmisɛnnin bɛ barika sɔrɔ ka taa a yɛrɛ sɔgɔsɔgɔ pewu ani ka Ragdoll-floppy (hypotonia) walima a bɛ barika gɛlɛya ni a dakunw gɛlɛnw ye ani a kɔ bɛ kɛ kurukuruni ye (hypertonia walima opisthotonos).
7. Jaabi hakɛ caman caman cili: Den bɛ barika sɔrɔ a tɛ se ka a kan ni a magali la, a bɛ a ɲɛw filɛ ni ɲɛw ye minnu bɛ i n’a fɔ galasi, walima a tɛ hakili bɔ.
8. A ɲɛfɔlen tɛ tariku ni farikolo sɛgɛsɛgɛli kɔfɛ: Ni kɔrɔtɔko dɔgɔtɔrɔ ye tariku caman ta ka den sɛgɛsɛgɛ k’a ta a kun na ka taa a bila a sen na, a sababu jɛlen tɛ yen joona. Misali la, ni den min ka sumaya hakɛ ye degere 39,2 ye ani a disi bɛ kɔsegin kosɛbɛ, o ye ninakili jɔ, o sɛgɛsɛgɛli ye banakisɛfagalanw walima sɔgɔsɔgɔninjɛ ye, o tɛ ɲɛfɔli kɛbali ye BRUE.

Tabali min bɛ tali kɛ ɲɔgɔn na: BRUE min ka farati ka dɔgɔ ni BRUE min ka farati ka bon ni min tɛ BRUE ye¶

Ka faamuyali sɔrɔ ni den bɛ bin Fara dɔgɔyalen na BRUE walima Faraba min bɛ a la BRUE kulu b’a fɔ i ye tigitigi sɛgɛsɛgɛliw ni dɔgɔtɔrɔso kɔlɔsili minnu bɛna kɛ kɔrɔtɔko jɛkulu fɛ. Ni denmisɛnni ma se ka hali kelen kɛ Farati dɔgɔyalen sariyaw la, u bɛ jate Faraba la BRUE.

Fɛn dogolenw minnu bɛ mɔgɔ ka ɲɛnamaya bila farati la, olu sɛgɛsɛgɛra High-Risk BRUE kɔnɔ¶

Mun na kɔrɔtɔko dɔgɔtɔrɔw bɛ u sinsin ka taa dɔgɔtɔrɔso la min bɛ wele ko High-Risk BRUE denmisɛnninw (i n’a fɔ den o den si tɛ tile 60 bɔ walima den o den min ye ciyɛn filanan kɛ) ka taa dɔgɔtɔrɔso la hali ni den bɛ nisɔndiya ani ka buteli min kɛnɛyaso kɔnɔ? Sabula denmisɛnni fitiniw na minnu ka farikolojidɛsɛ ma kɔgɔ, bana wolonwula minnu bɛ se ka u ka ɲɛnamaya bila farati la, olu ka teli ka na ni fiɲɛnabɔli walima sɔgɔsɔgɔninjɛ ye min tɛ makun, min bɛ a dan na, o ye u taamasiɲɛ fɔlɔ yɛrɛ ye sani taamasiɲɛ kɔrɔw i n’a fɔ sumaya walima sɔgɔsɔgɔ ka bɔ.

1. Laryngospasme ani Laryngeal Chemoreflex (LCR) ka bɔ kɔsegin na¶

Denmisɛn kɔrɔbaw ni mɔgɔkɔrɔbaw la, ni kɔnɔbara asidi walima daji dɔɔni magara kankɔnɔna na (larynx), kunsɛmɛ bɛ sɔgɔsɔgɔ jugumanba bila mɔgɔ la walasa ka fiɲɛbɔyɔrɔ saniya. Nka, den kuraw ni denmisɛnniw na minnu si tɛ kalo 4 fo kalo 6 bɔ, ɲɛgɛnɛsira sanfɛla bɛ den ka ɲɛnamaya kɛcogo fɔlɔ dɔ daminɛ min bɛ wele ko Laryngeal Chemoreflex (LCR) (a dabɔra ka den bali ka kɔnɔbara basigilen fiyɛ kɔnɔbara la). Ni nɔnɔ min bɛ segin kɔ walima kɔnɔbara asidi jɛlen dɔɔni dɔɔni dɔɔni sera den da kɔfɛla makuntɔ, kan siraw bɛ siri kosɛbɛ laryngospasm complet la, cɛmancɛ kunsɛmɛ ninakili bɛ jɔ, ani vagus nerve bɛ dusukun tantanni sumaya (bradycardia).

• Bangebagaw bɛ min ye an waati la LCR spell: A ka c’a la, o yɔrɔ in bɛ kɛ ni den dalen bɛ a kɔ la miniti 15 fo miniti 60 dumuni dilen kɔfɛ (walima a sɔgɔlen kɔfɛ dɔrɔn). Den bɛ barika sɔrɔ ka gɛlɛya, k’u kɔ kuru, k’u ɲɛw da wuli siran fɛ, ka da kɛ ni makun ye walima ka disi lamagacogo gɛlɛnw kɛ ni mankan zeru ye, ka kɛ bilen bilenman jɛman ye, ka tila ka kɛ bulu ye a dawolo lamini na, ka laban ka sɔgɔsɔgɔkanba dɔ bɔ (inspiratory stridor) segin 20 fo 45 kɔfɛ ni kumakanw bɛ lafiya.
• Dɔgɔtɔrɔso teliya la: Aw bɛ den wuli u kɛrɛ fɛ walima k’u jɔ ka kɛɲɛ ni degere 45 ye ka kɛɲɛ ni aw disi ye, ka nɔnɔ yelen sama nɔgɔya la ka bɔ nugu la ni pikirijikɛlan nɔgɔlen ye (barisa denmisɛn minnu si tɛ kalo 4 bɔ, olu ye nugu ninakili wajibiya), ani ka fiɲɛ nɛnɛman dɔ fiyɛ u ɲɛda la. Aw kana bolokɔnincinin waajibiya ka jigin dawolo la abada.

2. Sugunɛbilenni (sɔgɔsɔgɔninjɛ) ani RSV sɔgɔsɔgɔninjɛ¶

Bangebagaw bɛ den makɔnɔ min bɛ ni banakisɛ (Bordetella pertussis) walima Finakilibanakisɛ (RSV) ka sɔgɔsɔgɔ walima sumaya mankanba, hakɛlama sɔrɔ. Denyɛrɛni minnu si tɛ kalo 3 bɔ**, o miirili bɛ se ka mɔgɔ faga:

• Fiɲɛ bilali sani sɔgɔsɔgɔ ka kɛ: Den bangenenw ni den fitini minnu si tɛ dɔgɔkun 8 bɔ, olu kɛmɛsarada la, fo ka se 50 ma RSV walima kɔnɔboli min bɛ bɔ balimakɛ kɔrɔba dɔ fɛ walima baliku dɔ fɛ min ka "farigan bɛ mɔgɔ dimi" dɔɔni dɔɔni, ni ninakilidegun barikama (ni bɛ ninakili jɔ fo sekɔndi 20 fo 60 ani ka kɛ bulu ye) ye kɛnɛyaso taamasiɲɛ fɔlɔ yɛrɛ ye, o bɛ kɛ lɛrɛ 24 fo lɛri 48 sani sɔgɔsɔgɔ, kɔnɔboli walima sumaya si ka kɛ.
• "Whoop" tɛ yen: Denmisɛnnin fitininw tɛ disi kogo fanga sɔrɔ walasa ka sɔgɔsɔgɔninjɛ "whoop" mankan klasiki inspiratoire dilan. O nɔ na, u bɛ u da tugu u makun na fiɲɛbɔyɔrɔ nɔgɔ nɔrɔlen na min bɛ kɛ ni mikroskɔpi ye, u bɛ sɛgɛn, u bɛ ninakili jɔ, ka dusukun tantanni jugumanba sɔrɔ. Sabula den min bɛ ni sɔgɔsɔgɔninjɛ ye joona walima RSV bɛ se ka kɛ i n’a fɔ a bɛ cogo la pewu waati daminɛw ni ɲɔgɔn cɛ ka sɔrɔ ka ninakili dabila kudayi sunɔgɔba waati la sanga 6 o kɔfɛ, kɔrɔtɔko ɲɛmɔgɔso bɛ nugulatumu kɛ ** .PCR sɔgɔsɔgɔninjɛ minnu bɛ kɛ ka Pertussis ni RSV** ani ka denmisɛnni fitiniw bila u ka u ka dusukun tantanni oksimɛtiri ni ninakilidegun kɔlɔsilanw na minnu tɛ ban.

3. Dusukun kanalpathies (Syndrome QT jan, WPW, ani defaites dépendantes de ductal) .¶

Barika la, denmisɛnnin bɛ kɛ finman, nɛrɛmuguma, walima nɛrɛmuguma ye i n’a fɔ jinɛ (pallor) ani ka taa sɔgɔsɔgɔ i n’a fɔ ragdoll bɛ to ka dusukun walima vagal sanni ka kɛ ninakili. Denmisɛn kelen-kelen bɛɛ jateminɛna ka a BRUE (Faraba dɔgɔman ni faratiba fila bɛɛ) ka kan ka 12-lead electrocardiogramme (ECG):

• Syndrome de QT jan bangenen (LQTS) ani Brugada Syndrome: Dusukun kuran siratigɛ la, ion-channel de défauts genetiques bɛ se ka kɛ sababu ye ka tachycardie polymorphique ventriculaire (torsades de pointes) boli waati kunkurunninw, minnu bɛ u yɛrɛ ban. Sekɔndi 20 boli la, dusukun tantanni bɛ dɔgɔya ka se zeru ma, o bɛ den kɛ ɲɛ jɛman ye ani ka a sɔgɔsɔgɔ; ni a yɛrɛma bɛ segin ka segin sinus ritmɛ cogo la, den bɛ kunun ka ɲɛ, fo boli nata bɛ kɛ sababu ye ka dusukun bali yɔrɔnin kelen (SIDS).
• Wolff-Parkinson-Fɛn jɛman (WPW) ani Supraventricular Tachycardie ( .SVT): Denmisɛn minnu ka kuran sira wɛrɛ bɛ u dusukun na, olu bɛ se ka pan yɔrɔnin kelen ka se dusukun tantanni ma min bɛ se 240 fo 300 ma miniti kelen kɔnɔ, o bɛ kɛ sababu ye ka u fari jɛya yɔrɔnin kelen, ka u fari nɛrɛmuguma, ka balodɛsɛ bila u la, walima ka u yɛrɛ sɔgɔsɔgɔ waati kunkurunnin kɔnɔ.
• Dusukunnabana bangenen min bɛ sɔrɔ ductal-dependent ductal-dependent late-presenting walima ALCAPA: Jateminɛw i n’a fɔ aorte coarctation walima anomalous coronaire artérielle ka bɔ fogonfogon la (ALCAPA) bɛ se ka kasi barikama bila mɔgɔ la, ka sumaya, ka a fari ɲɛ, ani ka a sɔgɔsɔgɔ dumuni dili cɛsiri senfɛ.

4. Den bangenenw ni denmisɛnniw ka kirinni nɔgɔlenw (Denmisɛnniw ka sɔgɔsɔgɔninjɛ fana sen bɛ o la) .¶

Denmisɛn minnu si tɛ kalo 6 bɔ, olu tɛ i n’a fɔ denmisɛn kɔrɔbaw minnu ka yɛrɛyɛrɛli caman bɛ u la, u tɛ fili, u ka kunsɛmɛ siraw ka miyɛlini dafalen tɛ. O de kosɔn, kirinni min bɛ daminɛ waati walima kunsɛmɛ yɔrɔw la, a ka ca a la, o bɛ kɛ i n’a fɔ a yɛrɛmahɔrɔnya dɔrɔn walima motɛri kɛcogo nɔgɔlenw:

• Sɔgɔsɔgɔninjɛ: Den bɛ ninakili jɔ yɔrɔnin kelen, ka a ɲɛw filɛ fan kelen fɛ ni ɲɛw ye minnu bɛ i n’a fɔ galasi, ka a dawolo sɔgɔsɔgɔ, ka kan sɔgɔ, walima ka a senw lamaga cogo la min bɛ kɛ ni dɔnkili ye, ka tila ka kɛ bulu dibiman ye fo sekɔndi 30 fo sekɔndi 60.
• Denmisɛnniw ka sɔgɔsɔgɔninjɛ (Tilebin-yanfan-sɔgɔsɔgɔninjɛ): A ka ca a la a bɛ daminɛ kalo 3 ni kalo 8 cɛ, a ka ca a la den kununni walima a sunɔgɔra tuma min na, den bɛ kɛ ni jackknife flexion (jackknife flexion) ye waati kunkurunnin kɔnɔ, min bɛ kɛ sekɔndi 1 ka se segin 2 ma walima ka a kɔ, a kɔ ani a bolokɔniw janya, a ka ca a la o bɛ kɛ kuluw kɔnɔ kalo 5 fo 15 o san 5 segin kɔnɔ ani bangebagaw bɛ fili tuma caman na ko "reflux cramps" walima startle spells. Wideyo minɛni joona bangebagaw fɛ ani denmisɛnw ka hakiliɲagami sɛgɛsɛgɛli kɔrɔtɔlen dɔ (EEG) nafa ka bon walasa ka yiriwali kɔsegin banbali bali.

5. Farikoloɲɛnajɛ ni sukarodunbana filiw bangenenw¶

Farikoloɲɛnajɛbana minnu man teli ka sɔrɔ bange kɔnɔ (i n’a fɔ Asili-CoA Dehydrogenase dɛsɛ min bɛ kɛ ni cakɛda cɛmancɛ ye [MCADD], asidi tuluma oksidan dɛsɛ, urea cycle disorders, ani asidi organiques) bɛ den bali ka tulu maralen caman tigɛli kɛ sukaro ye ni a bɛ sunɔgɔ balo ni ɲɔgɔn cɛ. Ni denmisɛnni sunɔgɔra ka mɛn dɔɔni ka tɛmɛ a cogo kɔrɔ kan walima ni a tɛ balo ka ɲɛ, a joli sukaro bɛ dɔgɔya kosɛbɛ walima amoniyɔmu baga bɛ ɲɔgɔn sɔrɔ, o bɛ kɛ sababu ye ka sɛgɛn barikama bila a la, ka a sɛgɛn, ka ninakilidegun, walima ka a yɛrɛ tanga. Ni aw ye dilan kɛrɛfɛ teliya la joli sukaro, joli gazi, ɛlektroliti, ani laktati lajɛ kɔrɔtɔko yɔrɔ la, o bɛ farikoloɲɛnajɛ gɛlɛyaw dɔn o yɔrɔnin bɛɛ.

6. Banakisɛ dogolenw, ɲɛgɛnɛsiralabanaw, sugunɛbaralabana, ani denmisɛnniw ka botulisi¶

Denmisɛn minnu si tɛ tile 60 bɔ, banakisɛ jugumanba (i n’a fɔ sugunɛbilenni, kulu B Streptococcus walima E. coli banakisɛfagalanw daminɛ na, walima ɲɛgɛnɛsiralabanaw daminɛ na) bɛ to ka banakisɛfagalanw (kɔnɔna funteni dɔgɔya degere 36,0 / degere 96,8 duguma) walima kunsɛmɛnasumaya barikama ni farigan foyi tɛ a la. O cogo kelen na, joona denmisɛnninw ka botulizi (botulisimu). ka bɔ sigida buguri sɔgɔlenw munumunulenw na, o bɛ kɛ sababu ye ka kunsɛmɛnasumaya jigin, ka gag reflex jugu, ka sɔgɔsɔgɔninjɛ fara ɲɔgɔn kan, ani ka fiɲɛ bilali bali yɔrɔnin kelen.

7. Joginni min tɛ kɛ kasaara la (Abusive Head Trauma) ani baga don mɔgɔ la k’a sɔrɔ a ma kɛ ni laɲini ye¶

Kɛnɛyaso kalan minnu lajɛra ni... AAP a jira ko denmisɛnnin kɛmɛsarada la 1 ni 3 cɛ minnu bɛ na ni faratiba ye walima minnu bɛ segin ka kɛ BRUE bɛ ni kunkolo joginni jugumanba ye (denmisɛn yɛrɛyɛrɛ) ni joli-sira-funu dogolenw ye minnu bɛ kɛ sababu ye ka fiɲɛ bila cɛmancɛ la, hali ni kɛnɛma kurukuruw tɛ kunsigi la. O la, dɔgɔtɔrɔw bɛ fari sɛgɛsɛgɛli kɛ ka ɲɛ ka bɔ kunkolo la ka taa se sen na, ka ɲɛda ɲɛfɛla fontanɛli (yɔrɔ nɔgɔlen) lajɛ ni a bɛ kuru, ka sanfɛla dawolo kɔnɔna lajɛ ni dawolo ɲɛgɛnɛsira tigɛra, ani ka a lajɛ ni a kɛra balawu ye ni furaw ye minnu bɛ mɔgɔ lafiya (i n’a fɔ balikuw ka fariganji, difenhidramini, lidokayini/bɛnzokayini ɲinw jeli minnu bɛ kɛ yɔrɔ la minnu bɛ mɛtemoglobinɛmiya bila mɔgɔ la, walima opioid/cannabis (kansɛri) minnu tɛ sariya kɔnɔ).

Sunɔgɔ lafiyalen ni jɔyɔrɔfalen sɛgɛsɛgɛli BRUE kɔfɛ¶

Denmisɛnw ka ninakili jɔli ni siyanɔsi caman bɛ daminɛ ni positional obstructive asphyxiation ye, o bɛ kɛ ni den kunkolo gɛlɛn bɛ kɔrɔta ka taa ɲɛfɛ (neck flexion) o la u dawolo bɛ digi u disi la , k' u fiɲɛbɔlan nɔgɔlen ni kolotugudaw kin (trachea) da tugu, walima ni dilan nɔgɔlen janw ye gazi ɲuman fiyɛ u nugu lamini na. Ni aw bɛ bolifɛn kɔrɔtɔlen makɔnɔ walima aw seginnen kɔ so ka bɔ dɔgɔtɔrɔso la dɔrɔn, aw bɛ nin Sanɔgɔ-Sanɔgɔ ni jɔyɔrɔ-fiɲɛ-sira jateminɛ dafalen kɛ:

• Aw ka mobili sigilanw, wotoroninw, bouncers ani infant swings jateminɛ: Aw kana a to abada denmisɛnnin ka to sunɔgɔ la mobili sigilan kan ni a bɔra mobili kɔnɔ siɲɛ kelen, ani aw kana baara kɛ abada bouncy seat incliné, swing, walima sinji barajuru la i n’a fɔ sunɔgɔyɔrɔ min bɛ kɛ tuma bɛɛ. Ni mobili sigilan dɔ digilen don a basigilen nivolen kɔnɔ mobili kɔnɔ, a bɛ sigi yɔrɔ la min tɛ mɔgɔ tɔɔrɔ; ni a bilala so kɔnɔ dugumalan fla la, sigilan bɛ wuli ka taa ɲɛfɛ, o bɛ kɛ sababu ye ka den kura sunɔgɔlen kunkolo jigin ka bɔ a dawolo la ka taa a disi la, ka fiɲɛbɔyɔrɔ datugu a makun na (positional asphyxia).
• Audit Baby Slings and Soft Fabric Wraps: Denmisɛn minnu si tɛ kalo 4 bɔ ni u bɛ taa ni u ye sling walima wrap kɔnɔ, aw bɛ tugu T.I.C.K.S. sariya: aw bɛ a tabaga to Tight, In view waati bɛɛ (aw kana den ɲɛda datugu abada ni fini ye), Cka bɔnɛ fo ka se ka den kun sanfɛla susu, ka den dawolo Kept ka bɔ u disi la (a dɔgɔyalenba la, yɔrɔ min bɛ se baliku bolokɔni kelen ma a dawolo kɔrɔ), ani ka den kɔ Supported.
• Audit kɛ Crib walima Bassinet (ABCs of Safe Sleep): Sunɔgɔ waati bɛɛ (sunɔgɔ waati ni sufɛ waati) ka kan ka kɛ A kelen ye, ka bila Back kan (supine), Crib walima basinet matirili jɔlen, flakɛlen kan, min datugulen don ni fini ye min sirilen don kosɛbɛ dɔrɔn. Aw bɛ barajuru bɛɛ bɔ, bumperw minnu dilannen don ni buguri ye, sunɔgɔ bɔrɔ girinyalenw, DockATot cogo la sigilanw, baganw minnu falen don fɛnw na, ani bɔrɔw lajɔlenw.
• Audit Room Temperature and Overbundling: Ni a sumana kojugu, o bɛ denmisɛnnin ka kunsɛmɛnasumaya kɛcogo bali oksizɛni dɔgɔyali waati. Aw bɛ sugolan to degere 20 ni 22,2 cɛ (degere 68 ni 72) ani ka den don finimugu finman kelen na a caya la ka tɛmɛ baliku bɛ se ka min don ka ɲɛ (i n’a fɔ finimugu min bɛ ninakili, sunɔgɔbɔrɛ kɔnɔ min bɛ se ka don, ni a kunkolo ma datugu).
• Du kɔnɔ sisi ni vape aerosol tali jateminɛ: Nikotini, sigarɛti sisi, walima aerosol vaping tali ladonbagaw ka finiw kan, o bɛ denmisɛnninw ka hakili-la-banakisɛfagalanw tiɲɛ, o bɛ den ka se ka fiɲɛ bila ani ka kunun ni oksizɛni jiginna (auto-resuscitation).

Sigidaw ka kɔrɔtɔko nimɔrɔw ani baaradaw ka sariyaw¶

Ni ninakili jɔcogo ɲɛfɔlen tɛ, ni a kulɛri yera, walima ni a sen bɛ sɛgɛn, aw bɛ aw ka jamana ka anpulu kɔrɔtɔlen wele joona ani ka den cibaga ladɔnniya a si hakɛ tigitigi la dɔgɔkun walima kalo kɔnɔ:

• Amerika ani Kanada: Aw bɛ 911 wele joona furakɛli kɔrɔtɔlenw kama (EMS) ka taa ni a ye denmisɛnw ka kɛnɛyaso la min bɛ se ka kɔrɔtɔko ɲɛnabɔ. Dɔgɔtɔrɔso sɛgɛsɛgɛli bɛ tugu Amerika denmisɛnw ka kɛnɛyako Akademi (AAP) ani Kanada denmisɛnw ka tɔnba (CPS) BRUE dɔgɔtɔrɔso baarakɛcogo laadilikanw. Ni aw bɛ siga la ko aw ye du kɔnɔfɛn walima fura dɔ min bala la, aw bɛ Poison Control wele fana telefɔni 1-800-222-1222 (US) walima 1-844-764-7669 (Canada).
• Royaume-Uni: Aw bɛ 999 wele joona ka taa anpulu kɔrɔtɔlen na ni den ninakili jɔra, ni a kɛra bulu ye walima ni a ɲɛ ye bulama ye, walima ni a bɛ senna, ka taa ni den ye yɔrɔ la min ka surun aw la Denmisɛnw ka kasaara ni kɔrɔtɔko (A&E) baarakɛda. Dɔgɔtɔrɔso ka jateminɛ bɛ tugu Jamana ka kɛnɛyako ni ladonniko ɲɛtaa baarada (NICE) ani Masakɛ ka Denmisɛnw ka kɛnɛyako ni denmisɛnw ka kɛnɛyako kalanso (RCPCH) bange kɔfɛ binkanni barikama min ma labɛn (SUPC) ani BRUE laadilikanw. Ni aw b’a fɛ ka ɲininkaliw kɛ tuguni kɛnɛyaso kɔfɛ, aw bɛ NHS 111 wele.
• Erɔpu tɔnba: Aw ye 112 wele UE jamanaw bɛɛ kɔnɔ walasa ka denmisɛnw ka anpulu ci joona. Dɔgɔtɔrɔso ka sariyaw bɛ tugu Erɔpu lakununni jɛkulu (ERC) denmisɛnw ka ɲɛnamaya dɛmɛni jɔnjɔnw (minnu bɛ kisili ninakili fɔlɔ 5 jira sani disi degunni ka daminɛ ni 15:2 hakɛ ye furakɛlikɛla degelenw fɛ) ani jamana kɔnɔ denmisɛnw ka kɛnɛyako BRUE sariyakolow.
• Ɔsitarali ni Zelande kura: Aw bɛ 000 wele Ɔsitarali walima 111 Nuwɛlika walasa ka anpulu jaabi teliya la. Denmisɛnw ka kɔrɔtɔko baarakɛyɔrɔw bɛ tugu Denmisɛnw ka ɲininiw kɛli kɔrɔtɔko ɲɛmɔgɔsow la diɲɛ jɛkuluba (PREDICT) ani Masakɛ denmisɛnw ka dɔgɔtɔrɔso (RCH) Melbourne dɔgɔtɔrɔso baarakɛcogo laadilikanw ka ɲɛsin BRUE.
• Endi ni Azi Pasifiki: Aw bɛ 112 (Endi jamana ka kɔrɔtɔko nimɔrɔ), 995 (Singapore), 119 (Japon ni Kore Dugu), walima aw ka sigida kɔrɔtɔko nimɔrɔ wele (aw ye a bɛɛ lajɛ kɔrɔtɔko nimɔrɔw) ka taa dɔgɔtɔrɔso sabanan dɔ la min bɛ den bangenenw walima denmisɛnw ka kɛnɛyasoba la (NICU/ .PICU).

Ɲininkali minnu bɛ kɛ tuma caman na¶

Mun na n den kura ɲɛda kɛra bilen ye ka ninakili jɔ segin 10 kɔnɔ k’a sɔrɔ a bɛ sɔgɔsɔgɔ walasa ka banakɔtaa tɛmɛ? Yala o ye BRUE ye wa?¶

Ayi, ni den kɛnɛman bɛ a yɛrɛ degun ka banakɔtaa walima gazi tɛmɛ (ɲɛnabɔli bana jugu min bɛ wele ko denmisɛnninw ka disizi), u bɛ u muɲu fiɲɛbɔyɔrɔ datugulen dɔ la (Valsalva manɛwɛrɛ), o min bɛ to ka u ɲɛda kɛ bilen ye walima ka kɛ bilen ye ani ka u ninakili jɔ waati kunkurunnin kɔnɔ fo sekɔndi 5 fo 10 k’a sɔrɔ u senw bɛ sama ka taa san fɛ. Ikomi a sababu ye farikolo sɛgɛncogo ɲuman ye min jɛlen don ani den cɛmancɛ dawolo ni a kan tɛ kɛ bulu ye abada walima ka kɛ fin ye min bɛ i n’a fɔ jinɛ, Ameriki denmisɛnw ka kɛnɛyako kalanso bɛ kasi bilenni ni banakɔtaa nɔgɔlen bɔ BRUE ɲɛfɔli la k’a jɛya.

Ne den bolow ni a senw bɛ kɛ bulama ye dɔɔni ni ne ye u ka finimugu da wuli, hali ni u bɛ ninakili cogo bɛnnen na. Yala ne ka kan ka anpulu wele wa?¶

Kulɛri buluman min dan ye bolow, bolokɔninw, senw ani senkɔniw dɔrɔn de ye den bangenen kura walima denmisɛnnin fitinin na, o bɛ wele ko acrocyanose, wa o ye joli siraw kɛcogo ye min tɛ kojugu ye, min bɛ kɛ cogo la min bɛ kɛ ni fiɲɛ nɛnɛman ye, ni joli sira misɛnniw bɛ u lamini walasa ka den kɔnɔna sumaya. Aw bɛ den cɛmancɛ ɲɛgɛnɛsiraw lajɛ tuma bɛɛ: aw bɛ dawolo, kan, ɲinw, ani cɛmancɛ disi lajɛ yeelen ɲuman na. Ni kan ni dawolo sumayalen don ani ni u ɲɛ ye bulama ye ani ni den bɛ ninakili ka ɲɛ ani ni a kɔrɔtɔlen don, o ye acrocyanose ye min tɛ kojugu kɛ; ni dawolo, kan walima ɲɛda kɛra bulu, bulama, dibi, walima fin jɛman ye, o ye cɛmancɛ siyanosi ye, wa a bɛ weleli teliya la.

Yala ni ne den ye BRUE sɔrɔ min farati ka dɔgɔn, o kɔrɔ ye ko ne den bɛna sa SIDS (Syndrome de la de mort par l’infant) fɛ wa?¶

Denmisɛnw ka kɛnɛyako sɛgɛsɛgɛlibaw y’a jira ko denmisɛn minnu bɛ BRUE farati dɔgɔyalen sariyaw bɛɛ dafa (minnu si tɛmɛna tile 60 kan, minnu bangera kɔnɔmaya dɔgɔkun 32 kɔnɔ walima o kɔfɛ, ko surun kelen min kɛra miniti 1 kɔnɔ, CPR tɛ wajibiya, ani farikolo sɛgɛsɛgɛli ni ECG kɛcogo ɲuman na), olu ka saya barikama kɔfɛ, o farati ka dɔgɔn kosɛbɛ, min bɛ bɛn denmisɛnninw bɛɛ lajɛlen hakɛ ma. Sunɔgɔcogo gɛlɛnw degecogo gɛlɛnw (u kelen na, kɔ kan, denso jɔlen jɛlen na) nafa ka bon to den kelen-kelen bɛɛ bolo.

Mun na dɔgɔtɔrɔso kɔrɔtɔlen dɔgɔtɔrɔ y’a fɔ ko n kana yamaruya di ka joli sɛgɛsɛgɛli kɛ, ka kɔkolo ta, ani ka n ka kunkolo sɛgɛsɛgɛli kɛ n den BRUE la min farati ka dɔgɔn?¶

Ni denmisɛnni min si tɛmɛna tile 60 kan, o bɛ BRUE farati dɔgɔyalen sariya kelen-kelen bɛɛ wasa kosɛbɛ, wa ni farikolo sɛgɛsɛgɛli bɛ kɛ a cogo la pewu, kɛnɛyaso sɛgɛsɛgɛlibaw minnu kɛra denmisɛnnin ba caman kan, olu b’a jira ko joli bɔli min bɛ don mɔgɔ kɔnɔ, ka kɔkolo tigɛ, ka disi lajɛ, ani ka a kunkolo CT scan kɛ, o bɛ se ka sɛgɛsɛgɛli kɛ kɛmɛsarada la 1 jukɔrɔ kosɛbɛ, k’a sɔrɔ a bɛ denmisɛnnin bila fiɲɛ, dimi, jaabi nkalonmaw, ani banakisɛ minnu bɛ sɔrɔ dɔgɔtɔrɔso la. O nɔ na, ​​AAP ka laadilikanw ofisiyali b’a fɔ ko aw ka to ka lɛri 1 fo lɛri 4 kɛ ka dusukun tantanni oksimɛtiri kɔlɔsi, ka EKG kɛ ni plɔmu 12 ye min tɛ fɛn ye, ka nugulatumu kɛ ni siga bɛ a la ko kɔnɔboli bɛ a la, ani ka tugu-tugu ɲɔgɔn kɔ ni aw ka denmisɛnw ka dɔgɔtɔrɔ ye sanga 24 kɔnɔ.

Yala ne ka kan ka consumer smart-sock walima clip-on diaper breathing monitor san ne den ye BRUE sɔrɔ kɔfɛ wa?¶

Ameriki denmisɛnw ka kɛnɛyako kalanso ani Ameriki dumuniko ni furako ɲɛmɔgɔso bɛ bangebagaw laadi ko u kana u jigi da mɔgɔw ka smart-socks, kamera mats, walima diaper clips kan walasa ka SIDS bali walima ka denmisɛnnin kɔlɔsi min bɛ BRUE kɔfɛ, barisa dumunikɛlaw ka minɛnw bɛ to ka jolidɛsɛ sɔrɔ ka a sɔrɔ u bɛ alarma nkalonmaw lawuli. Ni a sɔrɔla ko BRUE faratiba bɛ aw den na, a bangenen kɔfɛ kojugu, walima dusukun/fiɲɛbɔyɔrɔw bana min ka kan ka kɔlɔsi so kɔnɔ, aw ka dɔgɔtɔrɔ kɛrɛnkɛrɛnnen bɛna dusukun ni ninakilila kɔlɔsilikɛlan dɔ sɛbɛn min bɛ se ka kɛ FDA fɛ, ka fara bangebagaw ka CPR kalan kan.

Danfara jumɛn bɛ BRUE kalo 2 den na ni ninakili minɛcogo cɛ kalo 14 den na?¶

BRUE bɛ sɔrɔ kosɛbɛ denmisɛnninw na minnu si tɛ kalo 12 bɔ, wa a ɲɛfɔli tɛ kɛ, a ka ca a la a bɛ kɛ sunɔgɔ waati, lafiɲɛ waati walima dumuni dili waati. O ni ninakilidegun tɛ kelen ye, a ka c’a la, ninakilidegun bɛ kɛ denmisɛnninw na minnu si bɛ kalo 6 la ka se san 6 ma, o yɔrɔnin bɛɛ la, fɛn jɛlen dɔ kɔfɛ: ka kasi ka bɔ dimi fɛ (spell bleu siyanotique) walima ka a sababu kɛ bɔgɔbɔgɔli misɛnnin barikama ye walima ka siran (spell fin pallid). U fila bɛɛ ka kan ka dɔgɔtɔrɔ ka jateminɛ kɛ u sɔrɔli fɔlɔ la, ECG fana sen bɛ o la walasa ka waati jɛmanw sɔrɔ.

Gafe minnu bɛ tali kɛ o ko la¶

• Ninakili minɛcogo (syncope bleue vs pale) ani denmisɛnninw ka ninakilidegun sɛgɛsɛgɛli
• Denmisɛnw ni denmisɛnw ka CPR ani u dawolo
• Denmisɛnw ka botulizi, mɔni kɛnɛ dunni, den ka bana min bɛ wele ko floppy baby syndrome, ani kɔnɔboli
• Den kuraw ka jaŋaniya, ɲɛgɛnɛsiralabanaw, sɛgɛn, ani farikolojidɛsɛ bɛ kɛ denso ɲiginnenw na
• Kɔrɔtɔko nimɔrɔw

Sosow ani ɲɛmɔgɔyaso ka bilasiralikan¶

• Amerika ka denmisɛnw ka kɛnɛyako kalanso (AAP, Etazuni): Dɔgɔtɔrɔso ka baarakɛcogo ɲɛfɔli: Ko minnu ɲɛfɔlen tɛ, olu ɲɛnabɔlen surun (BRUE) (Kɔrɔlen, ko minnu bɛ i n’a fɔ minnu bɛ mɔgɔ ka ɲɛnamaya bila farati la) ani Denmisɛnnin minnu farati ka dɔgɔn olu jateminɛni (Tieder ni a ɲɔgɔnnaw, Denmisɛnw ka kɛnɛyako) ani Baarakɛjɛkulu min ɲɛsinnen bɛ denmisɛnninw ka saya barikama ma sunɔgɔ lafiyalen ladilikanw kan.
• Kanada denmisɛnw ka tɔnba (CPS, Kanada): Acute Care Committee Practice Point: Ko min ɲɛfɔlen tɛ, o ɲɛnabɔcogo surun min bɛ kɛ ni farati dɔgɔman ye, o ɲɛnabɔli (BRUE) ka Denmisɛnninw.
• Jamana ka kɛnɛyako ni ladonniko ɲɛtaa baarada (NICE) ani denmisɛnw ka kɛnɛyako ni denmisɛnw ka kɛnɛyako kalanso masakɛya (RCPCH, Angletɛri): Ladilikanw ka ɲɛsin jiginni kɔfɛ binkanni barikama ma min ma labɛn (SUPC) ani Ko minnu bɛ i n’a fɔ u bɛ mɔgɔ ka ɲɛnamaya bila farati la denmisɛnninw na.
• Banaw kɛlɛli ni u kunbɛnni baaradaw (CDC, Etazuni): Dɔgɔtɔrɔso (Sɔgɔsɔgɔninjɛ) ni RSV Apnea (Sɔgɔsɔgɔninjɛ) ni RSV Apnea (Sɔgɔsɔgɔninjɛ) kɛnɛyaso la denmisɛnniw na minnu si tɛ kalo 6 bɔ.
• Diɲɛ kɛnɛyako tɔnba (WHO) ani diɲɛ jɛ-ka-baara jɛkulu min ɲɛsinnen bɛ lakununni ma (ILCOR): Denmisɛnw ka ɲɛnamaya sabatili dɛmɛni (PBLS) Bɛnkansɛbɛn dɔnniya kan ni furakɛli ladilikanw ye.