Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. S57-S62 (doi:10.1542/peds.2005-2000B)

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SUPPLEMENT ARTICLE

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

Gary S. Rachelefsky, MD^a, Suzanne Kennedy, PhD^b and Amy Stone, BA^b

^a Allergy Research Foundation, Inc, Los Angeles, California
^b Emergency Department Demonstration Program, Milwaukee, Wisconsin

Abbreviations: ED, emergency department • EDDP, Emergency Department Demonstration Program • AAAAI, American Academy of Allergy, Asthma and Immunology • RWJF, Robert Wood Johnson Foundation • QoL, quality of life • PI, principal investigator • CDC, Centers for Disease Control and Prevention

The first 300 words of the full text of this article appear below.

	EMERGENCY DEPARTMENT DEMONSTRATION PROGRAM RATIONALE

 
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:

Peter Gergen, MD, Agency for Healthcare Research and Quality

David Bergman, MD, American Academy of Pediatrics

Joann Blessing-Moore, MD, American College of Allergy, Asthma, and Immunology

Meyer Kattan, MD, American Thoracic Society

Stephen Redd, MD, Centers for Disease Control and Prevention

Irwin Redlener, MD, Children's Health Fund

Carol Costante, RN, MS, CSN, National Association of School Nurses

Virginia Taggart, MPH, National Heart, Lung, and Blood Institute

Seth Emont, PhD, MS, the Robert Wood Johnson Foundation

These experts extrapolated pediatric asthma information from the National Heart, Lung, and Blood Institute's Expert Panel Report 2⁶ to create a set of stand-alone, evidence-based guidelines . . . [Full Text of this Article]

Address correspondence to Gary S. Rachelefsky, MD, Allergy Research Foundation, Inc, 11620 Wilshire Blvd, Los Angeles, CA 90025. E-mail: gr@allergymedicalclinic.com

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