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movements, posture, or changes in tone; (vi) what resuscitative efforts were made
and the infant’s response to them; (vii) when the infant was last fed; (viii) how
quickly the infant returned to baseline behavior. The responses to these questions
may provide the physician with clues to the diagnosis. As an example, an 8month-old infant who was interrupted in a favorite activity, began to cry, turned
red and blue, and finally had several seconds of tonic–clonic motor activity likely
had a breath-holding spell. In contrast, a history of 40 minutes of cyanosis and
apnea in a now well-appearing child may be unreliable. Other recent events that
should be documented include symptoms of other illnesses, such as changes in
behavior, activity, and appetite, as well as recent trauma and immunizations.
TABLE 14.4
COMMON LIFE-THREATENING CONDITIONS THAT CAUSE APNEA
Pneumonia
Sepsis/meningitis
Hypoglycemia
Seizures
Intracranial hypertension
Shock
Ingestion (e.g., analgesics, sedatives, muscle relaxants)