Apnea, Pediatric, Emergency Medicine

Sarah M. Halstead Reviewed 06/2017
 


Basics

Description

  • Absence of respiratory airflow for a period of 20 sec, with or without decreased heart rate:

    • Central apnea:

      • Disruption in the generation or propagation of respiratory signals in the br...

Diagnosis

If the patient is apneic, treatment must commence at once. 

Signs and Symptoms

Apnea may be current, historical, or impending. 

History

  • Duration of apnea

  • State:

    • Asleep, awake, crying

    • Relationship t...

Treatment

Pre-Hospital

  • Respiratory support as indicated

    • High-flow oxygen if breathing resumes

    • Check/clear out upper airway

    • Bag-mask ventilation

    • Endotracheal intubation if continued apnea

  • IV access, cardiac ...

Follow-Up

Disposition

Admission Criteria

  • Patients who were or may become apneic should be admitted to an inpatient unit for appropriate monitoring. Those with persistent abnormal vital signs need intens...

Pearls and Pitfalls

  • Consider occult sepsis, especially in a neonate

  • Consider occult trauma

Additional Reading

  • Brand  AD, Altman  RL, Purtill  K, et al. Yield of diagnostic testing in infants who have had an apparent life-threatening event. Pediatrics.  2005;115:885–893.

  • Claudius  I, Kee...

Codes

ICD9

  • 327.23 Obstructive sleep apnea (adult)(pediatric)

  • 770.81 Primary apnea of newborn

  • 786.03 Apnea

ICD10

  • G47.33 Obstructive sleep apnea (adult) (pediatric)

  • P28.4 Other apnea of newborn

SNOMED

  • 13094009 ...

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