Asthma Referral Guidelines

Initial evaluation

Initial evaluation and management should include establishing diagnosis of asthma based on history and exam. Symptoms can include history of cough, recurrent wheezing, recurrent difficulty breathing, recurrent chest tightness that occurs or worsens at night or with exercise, viral infection, exposure to allergens and irritants, changes in weather, hard laughing or crying, stress, or other factors.

Initial management

Initial management should include patient education regarding the medical diagnosis, trigger avoidance, and trial of quick-relief and long-term controller medications (if clinically indicated)

• If confirmation of the diagnosis is needed: all patients ages 5 and older can undergo spirometry to determine that airway obstruction is at least partially reversible.
• If patient has persistent symptoms despite initial pharmacological trial.
• If there is a need to confirm respiratory allergen sensitization.

To refer a patient to allergy clinic, you can submit an appointment request via Cerner and a scheduler will contact the patient family to coordinate the appointment.  You can also provide the patient, family or your practice’s scheduler our appointment line: (202) 476-3016. Select the appropriate option to schedule an allergy appointment.  

• No prior testing is needed before referral.
• If the patient has had prior spirometry or respiratory allergen testing- a copy of those results would be helpful.
• Patient should bring the list of the medications that they have tried.
• If the patient is 5 years of age or older, they will likely be scheduled for spirometry either on the date of their initial allergy appointment or on another date if spirometry services are not available on that date.
• The initial visit might include allergy skin prick testing for respiratory allergens, if clinically indicated. Allergy skin testing is done typically if the patient is at least 4-6 years of age. Patient will need to be off oral antihistamines for 5-7 days prior to skin testing.
• The duration of the initial visit in the allergy clinic is between 60-90 minutes.