Inclusion Criteria:  Presenting to Children's Hospital of Michigan (CHM), Detroit, Emergency Department (ED) for an acute asthma exacerbation History of asthma as reported by parents  Exclusion Criteria:  Transfer from outside ED for a higher level of care Admitted to the hospital following pediatric ED evaluation Significant co-morbidity (pulmonary, cardiac, or other systemic disease) Hemodynamic instability Non-English speaking Previously enrolled in this study Patients without their primary caregiver at ED presentation Not under the care of CHM ED provider who has consented to be a part of the study