180217 - Identifying and managing risk factors for thunderstorm asthma

Thunderstorm asthma is an uncommon phenomenon where a large number of people, many of whom have never had a previous asthma diagnosis or treatment, experience asthma over a short period of time. It is thought to be triggered by high grass pollen levels and a specific type of thunderstorm.

In anticipation of grass pollen season, which typically runs from 1 October to 31 December in South Eastern states, an increased awareness of thunderstorm asthma is required in the community to increase resilience and reduce impacts, including saving lives. General practitioners (GPs) have a vital role in identifying both asthma and allergic rhinitis, and in optimising patient’s management and self-care.

This activity focuses on understanding the thunderstorm asthma phenomenon, identifying environmental and patient risk factors; identifying, managing and providing education for those at increased risk and managing your clinic’s preparedness for such events.

On 21-22 November 2016, Melbourne experienced the largest thunderstorm asthma event ever recorded; Melbourne and Geelong public hospital experienced:
• 9,909 total emergency department presentations – 3,643 (58%) more than expected
• 672% increase in respiratory-related presentations (3365 more than expected)
• 992% increase in asthma-related admissions (476 more than expected), including 30 extra in intensive care unit admissions for asthma
Nine more deaths occurred in people between 21 and 30 November with asthma reported as the primary cause of death, than would be expected.

In addition, there was a significant surge in ambulance calls, calls to Nurse-On-Call, pharmacy attendances and visits to general practice both during and after the event.

When emergency services were at maximum capacity, some practices experienced significant delays in the arrival of ambulances for transporting patients with acute asthma. Many practices also reported a flow on effect.

D1. Communication skills and the patient-doctor relationship

• Ways in which health can be optimised and maintained are communicated to patients, family members and carers

D2. Applied professional knowledge and skills

• Rational prescribing and medication monitoring is undertaken

D3. Population health and the context of general practice

• Current and emerging public health risks are effectively managed

D4. Professional and ethical role

• Duty of care is maintained

D5. Organisational and legal dimensions

• Rural health
• Adult health
• Care of older people
• Children and young people health
• Ear and nose medicine

National Asthma Council Australia and the Department of Health and Human Services, Victoria State Government