by Lenore Jarvis (EM) and Lisa Herrmann (HM), Children’s National

Take Home Points:
· ALTE is a description, not a diagnosis
· Routine screening tests are low yield – use HPI/PE to assess risk and tailor tests
o Wide range of practice for workup in the ED – frequently guided by history, physical exam and age of child
· Actions frequently affected by how straightforward the story is – more uncertainty in the history leads to more workup or increased likelihood of admitting
o Admission gives the benefit of time (which can be a screening test!)
o Patients are observed inpatient for 24 hours from the event
· Communication and how the episode and workup are framed for the parents/family are key
o Establish early that a diagnosis may not be obtained
o Assess for why event was scary – may inform about contributing factors at home (i.e. stress/overwhelmed, post-partum depression)