FEATURES/ DEFINITION

  • Apnoea
  • Colour change
  • Abnormal tone
  • Choking

DIFFERENTIAL DIAGNOSIS-

Capture-24

* from Dewolfe CC: review Pediatr clin north Am-2005

HISTORY

  • Description of event/Duration
  • Awake or asleep
  • Position (prone, supine, side)
  • Location (crib, bed)
  • Bedclothes, blankets, pillows
  • Activity at the time: feeding/coughing/gagging/choking/vomiting
  • Breathing efforts
  • Colour: Pallor/Central or Peripheral cyanosis.
  • Abnormal Movement or tone
  • Observations – a cough, vomiting, blood, or noise (silent, cough, gag, wheeze, stridor, crying)
  • Resuscitation Interventions
  • Present illness/Medical history
  • Fever/Poor feeding/Weight loss/Rash/Irritability/lethargy
  • Contact history
  • Medications/Immunization
  • Prenatal history/Birth history/Developmental history
  • Accidents/Family history/Congenital problems

BASELINE INVESTIGATIONS

  • Complete blood count (Infection, anaemia, blood cultures)
  • Liver function / Renal function ( calcium/ magnesium)
  • Lumbar puncture- Nasal swab for RSV / Pertussis culture
  • Inborn errors of metabolism (glycogen storage type I, fatty acid oxidation defects)
  • Arterial blood gases
  • Toxicology screen
  • Urinalysis (Infection/ Ammonia/ Toxicology)
  • Chest X-Ray (Infection, cardiomegaly)
  • ECG/ Holter   monitoring
  • Hypoxia -( Saturation monitoring)
  • Neoplasm/congenital abnormalities
  • Stool cultures
  • Radioisotope milk scan- for reflux
  • Brain imaging (CT/ MRI)
  • Radiologic skeletal survey

TREATMENT

  • Apnoea /saturation monitor for 12-24 hours OR longer as a diagnosis.
  • Basic life support training to parents.
  • Specific therapy, eg anti-reflux, antibiotics, child protection measures

FOLLOW UP

In few weeks.

 

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