Childhood Asthma: Management
M. J. Goldenhersh MD1
Gary S. Rachelefsky MD2
1 Clinical Instructor of Pediatrics, Department of Pediatrics, Division of Allergy and Immunology, University of California, Los Angeles; Diogy, of Allergy Research Foundation, Inc, Los Angeles
2 Clinical Professor of Pediatrics, Department of Pediatrics, Division of Allergy and Immunology, University of California, Los Angeles; Director of Allergy Research Foundation, Inc.
The goals of childhood asthma treatment are straightforward: facilitation of parent/patient understanding and acceptance of the disease prevention of patient physical and emotional disability. Patient/family education should be instituted at the time diagnosis is made, such that the patient and involved family members are familiarized with the short-term and long-term care that will be necessary. Setting realistic goals for asthmatic children that allow for a normal life-style (regular school attendance, participation in physical activities, etc) is helpful.
Successful management of childhood asthma requires knowledge, experience, and time. The demands on the physician can be tremendous. Patient management will be dictated by the age of the patient, the severity of the disease, and the social and financial resources of the involved family. The pediatrician with extra effort can provide appropriate care for the child with mild asthma. The moderate to severe asthmatic child (particularly those with evidence of chronic obstruction) are probably best managed by a team approach. Referral to a subspecialist who has the experience, updated knowledge, and time to institute both an educational and treatment program will benefit the patient with moderate to severe asthma (Table 1). The subspecialist assists in appropriate alteration of treatment plans in accordance with patient progress and may serve as a useful advisor to the pediatrician.
