PHARMACIES were called on to boost ventolin supply at Ballarat Health Services Base Hospital emergency department amid Monday night’s ‘thunderstorm asthma’ outbreak. The hospital had all but run out of ventolin with a sharp increase of people seeking help.
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The Base ED also averaged four ambulance arrivals per hour, between 6pm and 10pm, on Monday, predominantly presenting patients experiencing breathing difficulties.
Thunderstorm asthma is an epidemic of asthma symptoms during or immediately following a thunderstorm. It commonly affects young adults with a history of hay fever but not necessarily of asthma.
The rare phenomenon was particularly acute across Melbourne and Geelong, prompting a major disaster response from emergency services.
BHS physician Brett Knight said the outbreak was a constellation of environmental issues. A wet winter means rye grass pollen is high and rain in the thunderstorm caused the pollen to burst into tinier fragments than usual. These tiny fragments penetrate deeper into airways than usual, sparking asthma.
“We see it in patients who are sensitive to grass pollen but some of these cases were people who don’t normally have asthma,” Dr Knight said.
“The pollen burden is much more irritating.”
A Facebook post by The Courier this morning attracted almost 140 comments of Ballarat people citing hayfever symptoms or asthma for the first time, or first time in a long time, on Monday evening.
The last time the state experienced an outbreak of thunderstorm asthma was in 2010.
Dr Knight reiterated the importance of people inclined to experiencing asthma to ensure their asthma management plan was up-to-date with their general practitioner. This includes knowing correct puffer technique, access to reliever medication and regular and correct use of preventative medications.
“If there is a thunderstorm forecast, just be cautious about going outside,” Dr Knight said. “What happened in Melbourne in scale and intensity is not a common occurrence.”
Dr Knight said all Ballarat patients were effectively treated by Monday morning, thanks to a combined effort between hospitals, pharmacies and paramedics.
THUNDERSTORM ASTHMA
an epidemic of asthma symptoms during or immediately following a thunderstorm
WHAT CAUSED MONDAY'S EVENT?
* pollen blew into the city during the blustery day from the state's northern pastures
* pollen grains absorbed moisture during the evening thunderstorms and then burst into hundreds of tiny allergenic fragments
* those tiny fragments are small enough to penetrate deep into the airways, thus causing asthma
HOW MANY CALLS TO EMERGENCY SERVICES?
* 1900 triple-zero calls for ambulance from 6pm to 11pm - normally there would be about 345 calls in that time
* most nights Ambulance Victoria has 10 to 20 cases on hold but at one point on Monday some 190 cases were waiting
* last similar event in Melbourne was November 2010
* most calls were for patients in Melbourne's west
* people had asthma who'd never previously experienced breathing issues
* paramedics called in help from the MFB, police and doctors to deal with the spike in demand
* "We essentially had a day's workload within five hours," Ambulance Victoria's executive director emergency operations Mick Stephenson said on Tuesday
MONDAY'S POLLEN COUNTS
* Melbourne - extreme with 102 grass grains per m3 of air recorded
THE MISCONCEPTIONS
* "my hayfever turned into asthma" - one in four people with hay fever also have asthma and pollen can trigger both conditions
* "rain washes the pollen away" - the rain causes pollen to burst so rain can exacerbate discomfort for some
