Emergency Care of the Asthmatic Adolescent

Asthma affects an estimated 5-10% of children in the United States. The incidence is highest in the first several years of life. Few new cases are diagnosed during adolescence, and many children with asthma improve during the teenage years. Likelihood of remission, however, is related to severity of disease; thus asthma remains a major cause of morbidity in affected adolescents. Almost 30% of adolescents with asthma experience some limitation of activity. The authors focus on differential diagnosis, pathophysiology, evaluation of the acute episode, treatment, and related issues such as smoking, pregnancy, and the effects of chronic illness on the developmental tasks of adolescence. A special emphasis is placed on asthma mortality, which has increased dramatically in the United States since 1979, primarily among nonwhite children of lower socioeconomic status. An estimated 1-2% of patients with severe asthma die from the disease.