Medical Record Review
Managing Patients With Asthma: The Pediatrician as Emergency Physician, Chronic Illness Specialist, and Teacher
Asthma presents a number of challenges to the pediatrician. In its acute form, this disorder suddenly can render a child severely ill, with frightening respiratory distress and the small but real potential for death. Treatment of this emergency requires quick assessment, immediate decisions, and the coordinated use of potent medications that carry substantial power to harm. The pediatrician who deals most of the time with situations far less urgent must be prepared to take action with speed and accuracy.
At the same time, asthma is a disease that remains with patients for years or decades. Proper management of the asthmatic patient over the long haul involves knowledge of each patient's peculiar physiology as well as his or her lifestyle, environmental milieu, state of mind, reliability, and family situation. Although a few other conditions, such as seizure disorders, also require attention to both acute and chronic aspects, in terms of sheer numbers, nothing in general pediatric practice approaches asthma in demanding time, hard work, and the need for preparedness.
Management of this condition in recent years has changed significantly. Newer understanding of pathogenetic mechanisms has altered the approach to therapy. Technology has supplied better drugs and better ways of delivering them. Physicians need to keep up with the theoretical and practical information constantly being generated.
