Introduction:Enhancing the Role of the Emergency Department in the Identification and Management of Childhood Asthma

Childhood asthma rates have risen dramatically over recent years for reasons only partially understood. Although appropriate treatment and self-management techniques can frequently keep asthma symptoms under control, evidence demonstrates that asthma control eludes far too many children. An estimated 9 million (12.5%) children <18 years of age in the United States have had asthma diagnosed at some time in their lives.1 One of 3 children with asthma visits the emergency department (ED) because of an asthma-related event every year,2 and these visits cost 5 times as much as primary care visits for childhood asthma.3 Asthma represents 17% of all pediatric ED visits.4 Children aged ≤14 years accounted for 570000 ED visits in 1995 and 658000 in 1999.5 In the late 1990s, these disturbing patterns prompted leading allergy and asthma specialists Gary S. Rachelefsky, MD, a past president of the American Academy of Allergy, Asthma and Immunology (AAAAI), and Gail G. Shapiro, MD, also a past president of AAAAI, to convene a task force of asthma experts comprising medical association, government, foundation, and nonprofit agency representatives; their charge was to raise the standard of care for children with asthma. In addition to co-chairs Rachelefsky and Shapiro, task force members included: These experts extrapolated pediatric asthma information from the National Heart, Lung, and Blood Institute's Expert Panel Report 26 to create … Address correspondence to Gary S. Rachelefsky, MD, Allergy Research Foundation, Inc, 11620 Wilshire Blvd, Los Angeles, CA 90025. E-mail: gr{at}allergymedicalclinic.com