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). Even if your baby looks 100 percent alert, pink, and happy by the time you pick up the phone, every unexplained episode in an infant under 1 year old requires immediate medical evaluation by calling your local limooje caɗtuɗe (911 in the United States and Canada, 112 across the European Union, 999 in the United Kingdom) or going straight to a pediatric emergency department. What looks like a harmless 20-second pause can be the first warning sign of apneic pertussis (whooping cough), respiratory syncytial virus (RSV), cardiac arrhythmia such as Long QT Syndrome, congenital metabolic disease, or laryngospasm, and you must also know how to perform CPR sukaaɓe e cukalel e ɓuuɓri rescue and distinguish an infant BRUE from toddler breath-holding spells and infant apnea walla infant high fever and febrile seizures.

Waɗde ɗum jooni¶

1. Place the infant flat on their side on a firm surface and check airway and breathing immediately. Do not hold a limp or unresponsive baby upright against your shoulder, because vertical posture drains blood away from the brainstem and allows a floppy head to slump chin-to-chest, pinching the soft windpipe shut. Lay the baby flat on their side (the infant recovery position) on a firm mattress, floor, or changing table so any refluxed milk or mucus drains out of the mouth rather than into the lungs.
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. Hakkille coktirgal walla winndu: (a) no foti leƴƴanɗe kewu nguu juutiri, (b) no foti leppi, ɗemngal, e yeeso (bulo/purple, ghostly white/gray, walla boɗeejo ɓuuɓɗo), © so tawii ɓanndu ɓiɗɗo oo yahrii no feewi (hypotonia) walla tiiɗɗo e arko ( ).hypertonia), e (d) ko ɓiɗɗo oo waɗata e nder hojomaaji 5 hade mum waɗde (ɗaanaade e dow ŋoral, jooɗaade e jappeere oto, ñamminde, ɓuuɓde, walla woyde).
5. Yah to departemaa emergency ɗoon e ɗoon hay so tawii ɓiɗɗo oo ina nanndi e 100 e nder teemedere jooni. Taa ndartin ɓiɗɗo oo les ngam ɗaanaade to galle, ɗaɓɓa yeewtere subaka to doktoor sukaaɓe. E nder sukaaɓe ɓe keɓaani lebbi 12 (haa teeŋti noon e sukaaɓe ɓe keɓaani balɗe 60 walla jibinaaɓe ko adii nde ɓe keɓata jonte 32), ɓuuɓri apnee 30 sekonndiire ina heewi wonde kewu sentinel ko adii waktuuji ɗiɗmi, ɓurɗi juutde, baawɗi bonnude nguurndam.
6. Foto ɗanngal walla nokku ɗo ɓiɗɗo oo ñamlata ɗoo e addude ñamri ndi ɓiɗɗo oo, leɗɗe mum, e doggol toppitiiɓe ɗum to suudu safrirdu too. Ko adii nde njaltataa walla nde mawɗo goɗɗo ina paccira, ƴettu foto smartphone yaawɗo ɗo ɓiɗɗo oo lelni ɗoo (becce, bassinet, ɗaaniiɗo ŋoŋɗi, joɗnde witamin d, walla b herbal teething gels, walla leɗɗe coofɗe galleeji ngam safrooɓe urgency mbaawa waɗde ƴeewndo timmungo safe-sleep e toxicology.

Lekki pellital : Waylo-waylo weeyo cukalel ɗoon e ɗoon, foofaango, walla ɓuuɓri¶

flowchart TD
    A["Infant under 12 months suddenly stops breathing, turns blue/pale, or goes limp/stiff"] --> B{"Lelnude bannge + ɓuuɓnude sternum / ɓuuɓnude sole fotde 5 haa 10 sec. Mbele fooftere ina warta?"}
    B -->|"Alaa: Jaabaaki kadi foofaani no haanirta nii"| 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) to describe any frightening episode in an infant that made a caregiver fear the baby was dying. Clinical research subsequently proved that 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) retired the term ALTE and established the strict, objective diagnosis of BRUE (Brief Resolved Unexplained Event).

The 4 mandatory pillars of a BRUE diagnosis¶

A physician will classify an infant's episode as a BRUE only if the child is younger than 12 months (1 year) of age and the episode satisfies all four of the following diagnostic pillars:

1. Brief (Duration under 60 seconds): The entire abnormal episode lasted less than 1 minute (most true BRUE episodes last between 10 and 45 seconds). If the episode lasted 1 minute (60 seconds) or longer, it exceeds the brief threshold and is automatically triaged into the High-Risk diagnostic pathway.
2. Resolved (100 percent return to baseline): By the time the infant arrives for medical evaluation, the baby has returned completely to their normal baseline state of health. Their heart rate, respiratory rate, oxygen saturation, temperature, skin perfusion, muscle tone, and eye contact must be completely normal. If the baby remains drowsy, lethargic, tachypneic (breathing fast), febrile, or irritable, the event is not a resolved BRUE, it is an active medical emergency requiring immediate resuscitation and targeted workup.
3. Characterized by at least 1 of 4 specific objective changes:
4. Central cyanosis or pallor: A clear blue, purple, dark dusky, or ghostly white/ashen color change involving the lips, tongue, gums, face, or central trunk. (Harmless bluish hands and feet when cool, known as acrocyanosis, or temporary redness around the mouth while crying or passing stool does not qualify as a BRUE).
5. Absent, decreased, or irregular breathing: A true pause in breathing (apnea), shallow gasping, or sudden choking/struggling for air. (Normal newborn periodic breathing, where a sleeping baby takes several rapid breaths followed by a 5-to-10-second pause while staying completely pink, is normal physiology and not a BRUE).
6. Marked change in muscle tone (hypotonia walla hypertonia): The infant suddenly goes completely limp and Ragdoll-floppy (hypotonia) or suddenly stiffens with rigid extremities and an arched back (hypertonia walla opisthotonos).
7. Altered level of responsiveness: The infant suddenly becomes unresponsive to voice and touch, stares blankly with glassy eyes, or loses consciousness.
8. Unexplained after history and physical examination: Once the emergency physician takes a detailed history and examines the baby from head to toe, there is no obvious immediate cause. For example, if a baby with a 39.2 degrees Celsius (102.6 degrees Fahrenheit) fever and severe chest retractions pauses breathing, the diagnosis is viral bronchiolitis or sepsis, not an unexplained BRUE.

Comparison table: Low-Risk BRUE vs. High-Risk BRUE vs. Non-BRUE Mimics¶

Understanding whether your baby falls into the Low-Risk BRUE or High-Risk BRUE category tells you exactly what tests and hospital observation the emergency team will perform. If an infant misses even one of the Low-Risk criteria, they are classified as High-Risk BRUE.

Sabaabuuji cuuɗiiɗi kulɓiniiɗi nguurndam ƴeewndaaɗi e BRUE High-Risk¶

Hol ko waɗi safrooɓe emergency ina tiiɗnoo e jaɓde High-Risk BRUE cukalel ngel (hono kala cukalel ngel duuɓi mum njahrata e 60 walla kala cukalel ngel jogii mboros ɗiɗaɓo) to safrirde hay so tawii cukalel ngel ina ƴakka ina yara butelaaji e nder suudu safrirdu ? Sabu e nder sukaaɓe tokosɓe wonduɓe e nerve autonome mo alaa ko waawi, ngonkaaji jeeɗiɗi kulɓiniiɗi nguurndam ina keewi feeñde e apnea silent, isolated walla limp spell ko maande mum en adannde hade maale kiiɗɗe ko wayi no nguleeki walla ɓuuɓri meeɗde feeñde.

1. Laringospasm e Kemorefleks Laringo (LCR) ummoraade e reflux¶

E sukaaɓe mawɓe e mawɓe, so toɓɓere asid reedu walla ƴiiƴam memii ƴiye daande (larynx), ƴiiƴam ngaandi ina ummina ɓuuɓri tiiɗndi ngam laaɓtinde laawol henndu. Kono e nder sukaaɓe jibnaaɓe e sukaaɓe ɓe duuɓi mum en njahrata e lebbi 4 haa 6, ƴiiƴam ɗam ina addana ɓiɗɗo oo feere wuurde, wiyeteende Laryngeal Chemoreflex (LCR) (ko feewti e haɗde ɓiɗɗo jibinannde foofde ndiyam ɗam e nder reedu). So toɓɓere tokosere ɓuuɓnde walla asid reedu laaɓɗo yettiima caggal daande cukalel ngel e nder deeƴre, ƴiye daande ɗee ina njuutee no feewi e nder laryngospasme timmuɗo, foofaango ɓalndu hakkundeejo ina dartoo, nerf vagus ina leeltina dogdu ɓernde (bradycardia).

• Ko jibnaaɓe njiyata e nder an... LCR spell: Episode oo ina heewi waɗde nde cukalel ngel ina lelii e dow koyɗe mum en 15 haa 60 minit caggal nde ngel ñamli (walla caggal nde ngel ngel ngel ɓuuɓti). Ɓiɗɗo oo ɗoon e ɗoon ina yaha ina tiiɗi, ina ɓuuɓna ɓalndu mum, ina uddita gite mum e kulol, ina waɗa hunduko deƴƴungo walla dille ɓalndu ɓuuɓɗe e daande zero, ina wayloo boɗeejo jalboowo, caggal ɗuum ina ɓuuɓtoo e saraaji leppi ɗii, haa jooni ina yaltina ɓuuɓri toowndi (inspiratory stridor) caggal leƴƴanɗe 20 haa 45 nde ƴiye ɗee ɓuuɓtata.
• Naatgol e leeso ɗoon e ɗoon: Wirlo cukalel ngel e dow bannge mum walla jogaade ngel e dow ŋorol 45 degere e dow ɓanndu maa, ɓuuɓna ngel no feewi kosam yiyteteeɗam e nder hunuko hee e ɓuuɓri softundi (sabu cukalel ngel alaa lebbi 4 ko obligate nasal breathers aek maɓɓe), and Hoto meeɗ doole junngo les daande.

2. Ɓuuɓri apneik (ɓuuɓri ɓuuɓndi) e bronkiyolitis RSV¶

Jibnaaɓe ina ɗaminii ɓiɗɗo mo ɓuuɓri (Bordetella pertussis) walla Virus Sinsitiyaal Fooftere (RSV) to have a loud, hacking cough or fever. In infants under 3 months of age, that assumption can be fatal:

• Apnea before the cough: In up to 50 percent of neonates and young infants under 8 weeks old who contract RSV or pertussis from an older sibling or adult with a mild "annoying cold," sudden central apnea (stopping breathing for 20 to 60 seconds and turning blue) is the very first clinical sign, occurring 24 to 48 hours before any cough, congestion, or fever develops.
• Absence of the "whoop": Young infants do not have the chest wall strength to create the classic inspiratory "whoop" sound of whooping cough. Instead, they gag silently on sticky microscopic airway mucus, become exhausted, pause breathing, and develop profound bradycardia. Because a baby with early apneic pertussis or RSV ina waawi ndaarde no feewi hakkunde balɗe gadane ɗee, caggal ɗuum woppa foofaango haa abada e nder ɗanngal luggiɗngal waktuuji 6 caggal ɗuum, departemaaji emergency mbaɗata ko nasofaringeal PCR ɓuuɓri ngam Pertussis e RSV e jogaade sukaaɓe tokosɓe e monitoruuji pulse oximetry jokkondirɗi e apnée.

3. Kanalopatiiji ɓernde (Sindrome QT juutɗo, WPW, e ŋakkeende fawaade e ductal)¶

Episode ɗoon e ɗoon ɗo cukalel ngel waylata daneejo, daneejo, walla ɓuuɓɗo (pallor) e yahde limp no ragdoll ina heewi ɓernde walla vagal wonaa fooftere. Kala cukalel ngel ƴeewtaama ngam a BRUE (Low-Risk e Risk mawɗo fof) ina poti heɓde 12-lead elektorokardiyogram (ECG):

• **Sindoron QT juutɗo jibinaaɗo (LQTS). E nder dogdu 20 sekonnde aritmi, yaltoore ɓernde ina ustoo haa zero, ina wayla cukalel ngel ɓuuɓngel e ɓuuɓngel ; so tawii rimre ndee ina ɓuuɓtoo e hoore mum, ina artira e rimre sinus no woorunoo, cukalel ngel ummotoo ina ndaara no feewi, haa nde dogdu caggal ɗuum addanta ɓernde mum ustaade no feewi (SIDS).
• Wolf-Parkinson-Wite (WPW) e Takikardiya Supraventrikulaar ( ).SVT): Cukalel gonngel e laawol elektirik accessoire e nder ɓernde ina waawi diwde no feewi haa 240 haa 300 beat e nder hojomaaji, ɗum addana ɗum ɓuuɓde no feewi, ɓuuɓde ɓalndu, ŋakkere ñamri, walla sinkope juutɗo.
• Rafi ɓernde jibinannde ductal-dependent mo ɓooyaani walla... ALCAPA: Sarɗiiji ko wayi no coarctation aorta walla ƴiiƴam koronaawiris nano anomal ummoraade e ƴiiƴam ɓuuɓɗam (ALCAPA) ina waawi addande neɗɗo woyde, ɓuuɓde, ɓuuɓde, e ɓuuɓde e nder tiiɗnaare ñamminde.

4. Ɓoornugol cukalel e cukalel (ina heen ɓuuɓri cukalel)¶

Sukaaɓe mawɓe wonduɓe e ɓuuɓri gonndi e ɓuuɓri ndi alaa ko waawi heen wonde, sukaaɓe ɓe keɓaani lebbi 6 ina njogii myelination timmuɗo e laabi mum en cerebral cortex. Ko ɗum waɗi, ɓuuɓri epilepsi fuɗɗotoondi e nokkuuji gonɗi e sahaa walla e nder ngaandi ina heewi hollirde ko fenomaaji mooftugol laaɓtuɗi walla ɓuuɓɗi :

• Apneic seizures : Cukalel ngel ina woppa foofde ɗoon e ɗoon, ina ndaara bannge gooto e gite gilaasi, ina waɗa dille koyɗe rimɗinɗe, ina ɓuuɓna ɗemngal, walla ina ɓuuɓna welooji, ina wayla ɓuuɓol ɓuuɓngol fotde leƴƴanɗe 30 haa 60.
• Infantile Spasms (Syndrome de l’Ouest): Fuɗɗoraade ko ɓuri heewde hakkunde lebbi 3 e 8, ko ɓuri heewde ko nde cukalel ngel ummotoo walla nde ɗaaniima, cukalel ngel ina jogii ɓuuɓri juutndi, ɓuuɓri 1-to-2-sekonndi, ɓuuɓri gonndi e ɓuuɓri gonndi e ɓuuɓri gonndi e ɓuuɓri gonndi e ɓalndu nduu Leƴƴanɗe 5 haa 15 e jibnaaɓe ina keewi majjere ngam "crampes reflux" walla ɓuuɓri hulɓiniindi. Wideyoo gadano mo jibnaaɓe mbaɗi e elektorensefalogram (EEG) ina njogii nafoore ngam haɗde ƴellitaare duumiinde.

5. Juumre jibinannde e mbaydi mbaylaandi e ŋakkeende suukara¶

Ñawuuji mbayliigu jibinannde ɗi keewaani (ko wayi no Ɓooygol Asil-KoA Dehidrogenaas [ 1 ].MCADD], ŋakkeende oksidaasiyoŋ asid fattik, ŋakkeende cirƴam uree, e asideeji organik) ina kaɗa cukalel waylude asid mooftiraaɗo e glukos so ina hoora hakkunde ñameele. So cukalel ina ɗaanii seeɗa ko ɓuri ko woowaani walla ina ñaama no feewi, suukara e nder ƴiiƴam mum ina ustoo walla ina moofta amoniak tooke, ina addana ɗum ɓuuɓde no feewi, ɓuuɓde, ɓuuɓtude, walla ɓuuɓde no feewi. Ƴeewtaade sara leeso yaawngo glukos ƴiiƴam kapilaar, gaas ƴiiƴam, elektorolit, e laktat e nder departemaa emergency ina anndita ɗoon e ɗoon kiris metabolism.

6. Bakteriiji cuuɗiiɗi, meninjaasi, ɓuuɓri ƴiiƴam, e botulism cukalel¶

E nder sukaaɓe ɓe duuɓi mum en njahrata e balɗe 60, ñawu bakteriiji bonngu (ko wayi no ñawu nguu, mboros Streptococcus walla E. coli puɗɗotooɗo, walla meninjitis puɗɗotooɗo) ina heewi saabaade hipotermiya (nguleeki reedu ina les 36,0 degre Csiren8s9. walla ɓuuɓri apneeji ɗoon e ɗoon tawa alaa ko ɓuuɓnata. Ko noon kadi, law botulism cukalel gila e sporeeji duƴƴe taariindi ɓuuɓɗi ina addana jippagol tampere nerve cranien, ŋakkeende reflex gag, pooling saliva, e ɓuuɓri apnee obstructive sudden.

7. Ɓooygol ngol wonaa aksidaa (Abusive Head Trauma) e tooke ɗe nganndaaka¶

Janngirɗe kilinik ƴeewtaaɗe e... AAP hollirta wonde hakkunde 1 e 3 e nder teemedere cukalon gonkon e High-Risk walla recurrent BRUE ina njogii les trauma abusive de la tête (syndrome du bébé shaken) e hematomaaji subdural occults baɗooji apnee caɗtuɗo e nder ngaandi, hay so tawii alaa ko woni e ɓalndu nduu ko ɓuuɓri yaajndi. Ko ɗum waɗi safrooɓe ina mbaɗa ƴeewndo laaɓtungo e ɓalndu gila e hoore haa e koyɗe, ƴeewta fontanelle yeeso (toɓɓere softeende) ngam yiytude so ina ɓuuɓna, ƴeewta nder leppi toowɗi ɗii so ina ɓuuɓna, ƴeewta so tawii ko leɗɗe cemmbinɗe (hono gebenzo topcamine liphehydraine/ diphencamine cold drops, diphenzocamine cold drops, diphenzocamine cold drops, diphenzocamine cold drops, diphenzocamine cold drops, diphenzocamine cold drops, diphenzocamine cold drops, difenzocamine/ diphencamine cold drops, difenzocamine cold drops, diphenzocamine cold drops, diphenzomaine drops/ diphencamine cold drops, diphenzocamine cold drops, diphenzocamine/ diphencamine cold drops saabaade metemoglobinemiya, walla opioid/kanndaas mo haɗaa).

Ƴeewndo ɗanngal kisal e asfiksiyoŋ gonɗo caggal BRUE¶

Heewɓe e fooftere cukalel e ɓuuɓri siyanotik ina ummoo e asphyxiation obstructive positionnelle, ko ɗum waɗata so hoore cukalel teddungel ina ɓuuɓtoo yeeso (neck flexion) ko noon ƴiye maɓɓe ɓuuɓtortoo e nder ɓernde maɓɓe, ina ɓuuɓna ɓuuɓri maɓɓe softunde, kartilaaji (trachea) uddita, walla nde jolɗe leɗɗe softuɗe njaltini gaas karbonik e saraaji nofru mum en. So aɗa fadi jolngo e yah-ngartaa walla ko yaawi caggal nde ngartu-ɗaa galle maa gila e opitaal, waɗ ndee ɗoo Audit Safe-Sleep and Positional Airway timmungo:

• Audit Joɗnde Otooji, Strollers, Bouncers, e Infant Swings: Hoto meeɗ accude cukalel ngel heddoo ɗaanaade e nder joɗnde oto so yaltii e oto, kadi hoto meeɗ huutoraade joɗnde bouncy, swing, walla pillow nursing ngam ɗaanaade no woorunoo. So jooɗorde oto ɓuuɓnaama e nder ŋoral mum toowngal e nder oto, ina jooɗii e ŋoral ŋoral kisal ; so tawii ko e dow leeso suudu hoɗorde, jooɗorde ndee ina ɓuuɓtoo yeeso, ina addana hoore cukalel ɗaaniiɗo oo ɓuuɓde gila e ŋoral, ina ɓuuɓna laawol henndu (positional asphyxia).
• Audit Baby Slings e Wraps Fabric Soft: E nder sukaaɓe ɓe duuɓi mum en njahrata e lebbi 4, jolnooɓe e sling walla wrap, sahaa kala rewa e T.I.C.K.S. kuulal: jogaade joloowo Tight, In yiyde e kala sahaa (hoto meeɗ suɗaade yeeso cukalel ngel e mbaydi), Close haa heewi ngam muñde dow hoore cukalel ngel, jogaade ɓiɗɗo ngel Kn port off ɓernde maɓɓe (ko famɗi fof gooto mawɗo finger-width of the chi**p keep the **p
• Ƴeewto Ɓiɗɗo walla Bassinet (ABCs of Safe Sleep): Kala sahaa ɗanngal (waktu ɗanngal e jamma) ina foti wonde Alone, waɗeede e dow Back (supine), e dow Crib walla bassinet tiiɗɗo, ɓuuɓɗo, ɓuuɓɗo tan ko lefol ɓuuɓngol. Ittu denndaangal pillooji, bumperuuji quilted, saakuuji ɗanngal tedduɗi, jolɗe paddorɗe no DockATot nii, daabaaji ɓuuɓɗi, e ɓuuɓri loowndi.
• Temperature suudu ƴeewndo e ɓuuɓri: Ɓuuɓri ina ɓuuɓna ɓuuɓri ngaandi cukalel e nder sahaa ŋakkere oksijen. Waɗde suudu ŋoral hakkunde 20 e 22,2 degereeji Celsius (68 e 72 degereeji Fahrenheit) e ɓoornaade cukalel ngel ko ɓuri heewde e laylaytol gootol ɓuuɓngol ko ɓuri ko mawɗo ɓoornotoo e dow wellitaare (hono onesie cotton foofoowo e nder saak ɗanngal ɓoornorgal mo alaa teddeendi the unver,co).
• Ƴeewndo cumu cumu e aerosol vape e nder galle: Ƴeewndo nikotiin, cumu simme, walla aerosol vaping e comci toppitiiɗo ina bonna kemikal (chemoreceptors) ɓalndu cukalel, ina bonna no feewi mbaawka cukalel ngel ɓuuɓde e umminde so oksijen (oksijen)auto-resuscitation).

Limooje emergency diiwaan e porotokolle agence¶

So tawii cukalel maa ina wondi e foofaango ngo alaa ko firti, mbayliigu colour, walla ɓuuɓri, noddu ɗoon e ɗoon sarwiis ambulance ngenndiijo maa, humpita neldoowo duuɓi cukalel ngel tigi rigi e nder yontereeji walla lebbi:

• Leyɗeele dentuɗe Amerik e Kanadaa: Noddu 911 law ngam heɓde ballal safaara (EMS) nawde ɗum to departemaa emergency baawɗo safrude sukaaɓe. Triage opitaal ina jokki e Akademi Ameriknaajo ko faati e safaara sukaaɓe (AAP) e Fedde sukaaɓe Kanadaa (CPS) BRUE laabi gollal kilinik. So tawii a sikkii aɗa ñaama huunde walla leɗɗe e nder galle, noddu kadi Kontrol tooke e 1-800-222-1222 (Amerik) walla 1-844-764-7669 (Kanada).
• Dental Dowlaaji Dentuɗi: Noddu 999 ɗoon e ɗoon ngam ambulance emergency so tawii cukalel ngel woppii foofaango, ngel wayliima, ngel ɓuuɓtii, walla ngel ɓuuɓtii, nawtu cukalel ngel to nokku ɓurɗo ɓadaade Aksidaa sukaaɓe e Emergency (A&E) geeɓe. Ƴeewndo safaara ina jokki e Duɗal ngenndiwal toppitiingal cellal e toppitagol (NICE) e Koldaa laamɗo toppitiiɗo cellal sukaaɓe e cellal sukaaɓe (RCPCH) ɓuuɓri caggal jibinannde nde sikkaano (SUPC) e BRUE laabi. Ngam naamne jokkondire caggal nde njaltuɗaa, noddu NHS 111.
• Dental Orop: Noddu 112 e nder denndaangal leyɗeele jeyaaɗe e UE ngam neldude ambulance sukaaɓe e yaawre. Porotokolle kilinik ina njokki e Goomu Orop ngam wuurtinde (ERC) laabi ballal nguurndam sukaaɓe (kollitooji 5 fooftere hisnude adannde hade fuɗɗaade ɓuuɓnude ɓernde e 15:2 ratio wonande dokkuɓe heblaaɓe) e sukaaɓe ngenndiiji BRUE tolnooji.
• Ostraali e Nuwel Selannde: Noddu 000 to Ostarali walla 111 to Nuwel Selannde ngam jaabaade ambulance ko yaawi. Departemaaji cafrirɗe sukaaɓe ina njokki e Wiɗtooji sukaaɓe e nder departemaaji cafrirɗe Gollondiral hakkunde leyɗeele (PREDICT) e Ospitaal Sukaaɓe Laamɗo (RCH) Melbourne laabi gollal kilinik ngam BRUE.
• Inndo e Asii-Pacifik: Noddu 112 (limre limngal limngal lesdi Indiya), 995 (Singapuur), 119 (Japon e Koree du Sud), malla limngal limngal lesdi ma (ƴeew fuu limooje caɗtuɗe) e yahde to opitaal toowɗo mo suudu safrirdu sukaaɓe walla sukaaɓe (NICU/PICU).

Naamne keewɗe naamneede¶

Hol ko waɗi yeeso ɓiɗɗo am keso oo ina wayloo boɗeejo, ina woppa foofaango fotde leƴƴanɗe 10 ina ŋoŋɗi ngam saabaade ɓuuɓri ? Mbele ɗuum ko BRUE?¶

Alaa, so cukalel cellungel ina tiiɗi ngam yahde e ƴiiƴam walla gaas (ko ɗum huunde moƴƴere e ƴellitaare ina wiyee infant dyschezia), ina ɓuuɓtoo e laawol henndu udditiingol (manouvre Valsalva), ngol sahaa fof ina wayla yeeso mum boɗeejo walla boɗeejo, ina ustoo foofaango mum seeɗa fotde leƴƴanɗe 5 haa 10 tawa koyɗe mum ina pulla dow. Sabu sabaabu oo ko tiiɗnaare fisik laaɓtunde, tee leppi ɓiɗɗo oo e ɗemngal mum hakkundeewal meeɗaa waylude mbaydi bulo walla daneeri, Akademi Ameriknaajo ko faati e safaara sukaaɓe ina yaltina e sifaa ɓuuɓɗo woyde e ɓuuɓde ƴiiƴam e nder firo BRUE.

Juuɗe e koyɗe ɓiɗɗo am ina nanndi e ɓuuɓri seeɗa so mi udditii ɓuuɓri maɓɓe, hay so tawii ina foofa no haanirta nii. Mbele miɗo foti noddude ambulance?¶

Kosam ɗam ɓuuɓɗam, ɗam fawaaki e juuɗe, e koppi, e koyɗe, e koyɗe e nder cukalel jibinaaɗo walla cukalel tokosel, ina wiyee akrosiyanosis, ko ɗum huunde nde alaa ko bonnata, nde ƴiiƴam ɗam waɗata e henndu cooyndu, nde tawnoo ƴiiƴam tokosam ɗam ina ɓuuɓta ngam ustude nguleeki ɓalndu ɓiɗɗo oo. Waɗde sahaa kala ƴeewto-ɗee ƴiye ɓiɗɗo oo : ƴeewto-ɗee leppi, ɗemngal, ƴiye, e ɓalndu hakkundeeru e nder annoore moƴƴere. So tawii ɗemngal e leppi ina ngulla ina ɓuuɓna, ina ɓuuɓna kadi cukalel ngel ina foofa no moƴƴi, ina jeertina, ko akrosiyanosis mo alaa ko bonnata ; so tawii leppi, ɗemngal, walla yeeso ina mbaɗta ɓuuɓde, ɓuuɓde, ɓuuɓde, walla ɓaleere, ko siyanosis hakkundeejo, ina ɗaɓɓi noddaango ko yaawi.

Mbele heɓde BRUE Low-Risk firti ko ɓiɗɗo am ina jogori maayde e SIDS (Syndrome de la mort suffisante de l’infant)?¶

Wiɗtooji mawɗi baɗaaɗi e sukaaɓe ina kollita wonde sukaaɓe ɓe keɓaani denndaangal sarɗiiji BRUE Low-Risk (ɓurɓe balɗe 60, jibinaaɓe e yontere 32 walla caggal ɗuum, kewu gooto juutɗo e nder hojomaaji 1, alaa ko haani CPR, e ƴeewndo ɓanndu no woorunoo e ECG) ina njogii risk mo alaa ko waawi heen wonde so wonaa balɗe 60 yimɓe. Huutoraade aadaaji ɗanngal kisal (ko gooto, e dow ɓalewol, e nder ŋoral tiiɗngal) ina heddii e wonde huunde himmunde e kala cukalel.

Hol ko waɗi doktoor suudu safrirdu nduu wasiyiima yo mi yamir ƴeewndo ƴiiƴam, ƴeewndo ƴiiƴam, e ƴeewndo ngaandi ngam ɓiɗɗo am Low-Risk BRUE?¶

So tawii cukalel ngel duuɓi mum ɓuri balɗe 60 ina hesɗitina kala ko ina tolnoo e 100 000 mbuuɗu, ina jogii ƴeewndo ɓanndu nduu no haanirta nii, jarribooji keewɗi baɗaaɗi e nder safaara, tawi ina waɗi ujunnaaje ujunnaaje cukalel ngel, ina hollita wonde ƴiiƴam ɗam ina ƴettee, ina ƴettee e ƴiiƴam, ina ƴettee e nder reedu, ina ƴettee e nder reedu, ina ƴettee e CT scans cukalel to radiis, nafoore, njeñtudi fenaande, e ñawuuji keɓaaɗi e opitaal. E nder ɗuum, jamirooje AAP laawɗuɗe ina wasiyoo waktuuji 1 haa 4 ngam ƴeewde pulse oximetry jokkondirɗo, ECG 12-lead mo alaa ko bonnata, ƴeewndo nasofaringeal so tawii ina tuuma pertussis, e jokkondire ɓadtiiɗe e safroowo sukaaɓe maa e nder waktuuji 24.

Mbele miɗo foti soodde monitor fooftere smart-sock walla clip-on diaper caggal nde ɓiɗɗo am heɓi BRUE?¶

Akademi Ameriknaajo toppitiiɗo ko faati e safaara sukaaɓe e Fedde toppitiinde ko fayti e nguura e leɗɗe Amerik ina wasiyoo jibnaaɓe nde ngoppataa tuugnaade e smart-socks, kameraaji, walla jokkere enɗam ngam haɗde SIDS walla ƴeewtaade cukalel ngel caggal BRUE, sibu kaɓirɗe kuutorteeɗe ina keewi waasde hipoksemiya tawa ina njuɓɓina alarmuuji fenaande. So tawii cukalel maa ina wondi e BRUE (BRUE) mo alaa ko bonnata, walla rafi ɓernde/ɓalndu ina ɗaɓɓi ƴeewndo e nder galle, doktoor maa ina rokka ma ƴeewndo cardiorespiratory mo FDA laaɓtini, wondude e heblo CPR jibnaaɓe.

Hol ko seerndi BRUE e nder cukalel lebbi 2 e ɓuuɓri gonndi e fooftere e nder cukalel lebbi 14 ?¶

BRUE ina heɓtoo no feewi e cukalel ngel duuɓi mum njahrata e lebbi 12, tee ngel anndaaka, ngel heewi waɗde ko e ɗanngal, e fooftere, walla e ñaamde. E ko feewti heen, ɓuuɓri gonndi e foofaango ina heewi waɗde e sukaaɓe tokosɓe yahrooɓe e lebbi 6 haa duuɓi 6, caggal nde ɓuuɓri laaɓtundi : maa wonii woyde sabu mettere (ƴeewndo bulo siyanotik) walla ɓuuɓri tokosiri walla kulol (ɓuuɓri ɓaleeri pallid). Kamɓe ɗiɗo fof ɓe ɗaɓɓi ko ƴeewndo safaara e sahaa maɓɓe gadano, ina heen ECG ngam ƴeewde so tawii ko ɓuuɓri ɓaleeri.

Ardiiɓe jokkondirɓe¶

• Ɗaɗi ɓuuɓɗi (sinkope bulo vs. pale) e triage apnée cukalel
• CPR sukaaɓe e cukalel e ɓuuɓri
• Botulisme cukalel, ñaamde njuumri ɓuuɓndi, ñawu cukalel floppy, e ɓuuɓri ƴiiƴam
• Jaundice jibinaaɗo keso, kernicterus, letarji, e ŋakkeende ndiyam e paɗe ɓuuɓɗe ina limtee
• Limooje emergency

Fuɗɗoode e ardorde laawɗunde¶

• Akademi Ameriknaajo ko faati e safaara sukaaɓe (AAP, leyɗeele dentuɗe Amerik): Laabi gollorɗi safaara: Kewuuji juutɗi ɗi paamnaaka (BRUE) (Kewuuji ko adii ina nanndi e nguurndam) e ƴeewndo sukaaɓe ɓe ngalaa caɗeele (Tieder et al., Pediatrics) e Goomu gollordu ngam ƴeewde wasiyaaji ɗanngal kisal ngam ñawu maayde sukaaɓe.
• Fedde sukaaɓe Kanadaa (CPS, Kanadaa): Toɓɓere gollal Goomu toppitiingu cellal: Njuɓɓudi kewu mo laaɓaani (BRUE) e nder Cukalel.
• Duɗal ngenndiwal toppitiingal cellal e toppitagol (NICE) e Koldaa Laamɗo ngam Cellal Sukaaɓe e Cellal Sukaaɓe (RCPCH, Leydi Angalteer): Laabi ngam wiɗtude mboros korona mo sikkaano caggal jibineede (SUPC) e Kewuuji nannduɗi e nguurndam e nder cukaagu.
• Centres ngam haɓaade e reentaade ñawuuji (CDC, leyɗeele dentuɗe Amerik): Maandeeji ñawu nguu (Pertussis) e Apnea RSV e nder sukaaɓe ɓe keɓaani lebbi 6.
• Fedde Adunaare Cellal (WHO) e Goomu jokkondiral hakkunde leyɗeele ngam wuurtinde (ILCOR): Ballal nguurndam sukaaɓe (PBLS) Nanondiral e ganndal e wasiyaaji safaara.