Clinical Case 1

What further details do you want to know about the event itself?

You establish that he had fed an hour before and was napping in his cot. When mum checked on him, he was lying supine, did not appear to be breathing and was blue around the mouth. She picked him up and patted him on the back, when he then appeared to start breathing again and began to cry. There was no choking or vomiting. Initially, he was a bit limp but this soon resolved. She isn’t sure how long it lasted – but feels that it was seconds rather than minutes.

You also establish that he was a term delivery from an uncomplicated pregnancy. He is breast fed, feeds well, doesn’t often posset, is having plenty of wet and dirty nappies and is well in himself otherwise presently.

Family history and social history are unremarkable.

What specifically do you want to look for on examination?

Louis is awake and alert with normal observations, his measurements all plot on the same centile in his red book and his examination is normal. You cannot find a cause for his presentation, and so by definition, this is a BRUE.

How would you classify his risk category, and therefore the need for any further investigations?

How could you explain the event and attempt to manage Louis’s mum’s anxiety?