Emergency and critical care pediatricsAn update on the approach to apparent life-threatening eventsShah, Seemaa; Sharieff, Ghazala Qa,b Author Information aRady Children's Hospital and Health Center/University of California bPediatric Emergency Medicine, Palomar-Pomerado Health System/California Emergency Physicians, San Diego, California, USA Correspondence to Seema Shah, MD, FAAP, FACEP, Fellow, Pediatric Emergency Medicine, Rady Children's Hospital and Health Center/University of California, San Diego, 3020 Children's Way, MC 5075, San Diego, CA 92123, USA Tel: +1 858 966 8036; fax: +1 858 966 7433; e-mail: [email protected] Current Opinion in Pediatrics: June 2007 - Volume 19 - Issue 3 - p 288-294 doi: 10.1097/MOP.0b013e32815745a9 Buy Metrics Abstract Purpose of review Apparent life-threatening events are an ongoing diagnostic dilemma for clinicians. Since most apparent life-threatening event episodes occur in infants under 6 months of age, they can generate considerable anxiety in parents and providers. This review will discuss issues to consider in the evaluation of infants after an apparent life-threatening event. To ensure proper management, a systematic approach should be taken to attempt to determine the cause of the event. Recent findings More recent literature suggests that infants with apparent life-threatening events frequently present without signs or symptoms of illness. Obtaining a careful history and physical examination is essential in determining the cause of the event. In this article, we will review the most current literature and discuss the American Academy of Pediatrics new recommendations on sudden infant death syndrome prevention. Summary After a careful review of the literature, prone sleeping is one of the biggest risk factors for sudden infant death syndrome. The association between apparent life-threatening events and sudden infant death syndrome remains to be explored further, but current evidence suggests minimal risk after an apparent life-threatening event episode. This article will help clinicians prepare for this difficult challenge by providing up-to-date information and identifying problems to be addressed in future research. © 2007 Lippincott Williams & Wilkins, Inc.