Tag Archives: AAP

Brief Resolved Unexplained Event (BRUE) Instead of ALTE

We have been dealing with the term Apparent Life Threatening Event (ALTE) for decades. The AAP recently released new guidelines addressing this condition for the first time and have appropriately replaced the term ALTE with BRUE (Brief Resolved Unexplained Event) accurately reflecting the clinical situation.

ALTE renamed BRUE

These infants and small children often end up admitted to the hospital for overnight observation and cardiorespiratory monitoring. This is because there was a lack of national guidelines and pediatricians (including experienced and seasoned pediatricians) cannot be 100% confident that there isn’t a serious condition. Even the Nelson Textbook of Pediatrics does not have a chapter named ALTE and messages are confusing to say the least. Nevertheless, most of the times ALTE patients get discharged next day with no specific underlying pathology. This of course is a waste of resources and put families at unnecessary anxiety. Even the term itself (apparent life threatening) scares families and underscores the possibility of a serious underlying condition.

Research have found that most of these events resolve with no further consequences or complications and there is no statistically significant link to SIDS. Specially when major causes are ruled out (cardiac disease, epilepsy, child abuse, congenital malformations, sepsis, and respiratory apnea). Gastroesophageal reflux remains one of the most likely causes but that is not life-threatening unless associated with aspiration pneumonia and significant respiratory compromise.

Thank you AAP for saving us and now we can confidently tell these worried parents (Do Not Worry).

What is FAAP designation

The FAAP (also written with dots as F.A.A.P.) stands for Fellow of the American Academy of Pediatrics. I previously thought once you are a member of the academy (paying your dues and maintain ongoing commitment to children well-being advocacy) you can use it. I was wrong, FAAP designation can only be used when an AAP member has successfully passed the American Board of Pediatrics (ABP) initial certification exam and thereafter maintained active board certified status through the ABP’s Maintenance of Certification (MOC) program.


So you can see above the American Academy of Pediatrics have sent me a congratulations card saying that I can now use the FAAP designation along with (FAAPs care for kids) badge holder. They sent me that because I met two criteria; first I am an active AAP member and second because I just passed the ABP board exam. So now I can designate my name is Firas Salim, MD FAAP.

This is different from the ABP designation. The ABP (which is a different from the AAP) wants us to say Firas Salim, MD, ABP Board Certified in General Pediatrics. They specified that in a recent memorandum to all ABP certified pediatricians here is the link. However, in real practice, I did not see a pediatrician using that long designation after his/her name. Most folks just use the FAAP designation which implies that they are board certified.