Thunderstorm asthma final report

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Melbourne’s thunderstorm asthma event last year will result in a formal arrangement to facilitate the use of private hospital beds for public patients in times of high demand, after the event highlighted a gap in the system.

The ‘Review of response to the thunderstorm asthma event of 21-22 November 2016 Final Report’- released by the Victorian Inspector General for Emergency Services in April said the private hospital sector was called upon to help, but there was no formal arrangement in place for this to happen.

“The State Health and Medical Commander/State Health Coordinator (DHHS), supported by relevant DHHS staff, also called upon the assistance of private hospitals to assist with demand overflow from the public hospital system…As there was no formal arrangements to facilitate this type of activity, the change to procedure was authorised by the State Health and Medical Commander,” the report said.

However, the DHHS has now committed to “creating a predetermined and documented arrangement to facilitate the use of private hospital beds during times of extreme demand on the health system.”

Along with this, there were 16 recommendations in the report ranging from improved communication and a centralised online information system.

Releasing the report, Victorian Health Minister Jill Hennessy accepted the recommendations in principle, indicating work was already underway to implement them.

She committed $15.56 million in funding to be put towards a complete overhaul of the State Health Emergency Response Plan, more funding for emergency management training in hospitals and health workers, more research to improve understanding and treatment of thunderstorm asthma and improved real-time monitoring of data sources, including emergency department demand.

The pressure on all hospitals during the event was illustrated through the significant increase in patients presenting with respiratory illnesses over the two days. There were 231 additional presentations at private hospitals, 210 of which were attributed to respiratory illnesses.

Healthscope’s State Manager of Hospitals for Victoria and Tasmania, Andrew Currie said they treated close to 250 patients in the acute phase of the crisis, of which nearly 50 were classified as caused by the event.

“During the thunderstorm asthma event Healthscope’s Knox Private Hospital and John Fawkner Private Hospital’s Emergency Departments worked hand in hand with the Victorian Emergency Services and Department of Health to treat all patients affected.

“The staff in our hospitals responded quickly and opened up adjacent areas to the Emergency Departments to cope with the additional workload,” said Mr Currie.

Epworth HealthCare also experienced high demand. Managing Director of Epworth Richmond Emergency Department, Associate Professor Ron Sultana said there were 48 cases over the two days – a huge increase on their usual one or two cases per day for asthma related illnesses.

“Only a handful of patients needed to be admitted to the wards and therefore most patients were treated in the emergency by medical staff with ventolin, inhaled steroids and oral prednisolone before being discharged home.”

Consultant physician in respiratory medicine, allergy and sleep Dr Michael Sutherland said there were important learnings to emerge from the event, including better community awareness that even patients with hay fever may have serious asthma in these conditions and need to be prepared with an action plan.

“It was also notable that many at-risk people (including even asthmatics) did not know to stay indoors when the thunderstorm strikes. In addition, there was no standardised community warning system, which will hopefully be in place by the coming pollen season,” he said.

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