Key points

  • Paediatric respiratory medicine (PRM) was only recognised in some EU countries as a subspecialty of paediatrics in the 1970s; in many countries, there is still no such specialty.

  • In small hospitals, all paediatricians care for children with acute respiratory illness. Only large city hospitals have a dedicated paediatric respiratory medicine team, and few offer expertise in highly specialised areas.

  • Training in paediatric respiratory medicine varies greatly between countries – from an established course of several years to a simple determination of competence by a supervisor, regardless of period of training. The Paediatric HERMES syllabus aims to harmonise training standards across Europe.

  • The investigation and management of several conditions has now been standardised, but there is no internationally agreed guideline for many conditions, and those guidelines that do exist are often based on consensus rather than evidence.

  • Across Europe, there are obvious disparities in the number of PRM specialists and in the levels of morbidity and mortality from childhood respiratory conditions; these disparities should be addressed.

See the entire Paediatric respiratory medicine Chapter