Paediatric respiratory medicine (PRM) is a multidisciplinary subspecialty within the specialty of paediatrics, involving doctors, nurses, respiratory physiologists, physiotherapists, the child and the parent/caregiver. PRM first emerged as a subspecialty in some European countries in the 1970s when the European Paediatric Respiratory Society (EPRS) was formed. The EPRS and the Paediatric Assembly of the European Respiratory Society (ERS) existed alongside each other in the early 1990s, until the EPRS was incorporated into the ERS Paediatric Assembly in 1993. The major reason PRM emerged relatively late as a subspecialty of paediatrics was because respiratory problems were so common in children that all paediatricians were expected to be specialists in their diagnosis and management. While PRM is an established subspecialty in some European Union (EU) countries, this is by no means the case in all countries; countries that do not recognise PRM as a subspecialty include Finland, Greece, Italy and Spain. Among the EU countries in which PRM is recognised as a subspecialty, the typical ratio of paediatric to adult respiratory physicians is approximately 1:10, the same as the ratio of children to adults in the population. However, in some countries, the ratio of paediatric to adult respiratory physicians is as low as 1:50 (figure 1). The number of PRM specialists is not known in some countries, and it is likely that in many, there are simply no such specialists.
The aim of this chapter is to give an overview of PRM across Europe and not to focus on specific conditions.
As with all medical areas, PRM is in a state of constant evolution due to several different drivers (summarised in table 1). The present chapter therefore captures the situation in Europe in 2013 and is broken down into sections considering setting, training, standardisation of care, and developments, and ends with a brief summary that includes recommendations for the future.