(ALTEs) are a common presenting complaint to the emergency department. According to the National Institutes of Health 1986 definition – which remains the current definition – an ALTE is an episode that is frightening to the observer and is characterized by some combination of apnea, color change, change in muscle tone, and choking or gagging. In pediatrics, the observer sometimes fears that the infant has died.

Pediatric seizures are a common emergency department complaint. The prior definition of status epilepticus (SE) was: “More than 30 minutes of continuous seizure activity or two or more sequential seizures without full recovery of consciousness between seizures.”

Pediatric DKA management has always been fraught with concern regarding fluid management due to the risk of cerebral edema. While cerebral edema is uncommon, it has devastating complications and is always in the forefront of our management techniques.