BRUE scenario
candidate brief
4 month old Carlos was brought in by ambulance after an episode where he appeared to turn blue and floppy. Carlos is now active and back to normal. His observations are all normal. Take a history from his mother.
actor brief
This morning, as you were changing Carlos, he suddenly appeared to become floppy and blue. This lasted for about a minute before he started crying. There was no abnormal activity of his arms or legs, and no vomiting.
You called an ambulance straight awa y as you were terrified that he was dying. This has never happened before.
Since then he has had a feed, but you are afraid to put him down for his usual nap as you worry that it will happen again.
No recent illnesses. He is exclusively formula-fed and is feeding well. He seems to be putting on weight as expected.
Carlos was born at 38 weeks by spontaneous vaginal delivery, up to date with vaccinations, and he is your first child.
You are worried now that you are wasting everyone's time as he appears so normal, but you are worried that this will have a long-term effect on his health
examiner brief
- Wash hands - introduce self
- Confirm mother's identity + relationship to patient
- Specifically enquires about:
- location of child
- activity at time of the event
- breathing effort
- colour
- movement and tone
- observed cough or vomiting
- duration of the event
- any interventions undertaken (CPR etc.)
- any current illness
- Asks about birth and developmental history
- Asks about feeding history
- Asks about FHx
- Home environment
- Offers appropriate differentials
- Safe management plan
- Invites questions and addresses concerns
- Checks mother's understanding of management and plan