Respiratory storm

Abstract

Introduction and aim: To examine unusually high numbers of respiratory related presentations over a ten day period during late spring and early summer in 2010, coinciding with local thunderstorm activity. The impact to business continuity in the emergency department, secondary to a related surge in presentations, was also examined. This analysis will build on existing knowledge and literature around thunderstorm asthma.

Design and method: A retrospective cross-sectional descriptive approach was taken to analyse the event. Data was analysed retrospectively covering the period 08-17 November, trending respiratory presentations, with reference to seasonal variations experienced in the Australian Capital Territory (ACT), for the years 2009, 2010 and 2011. The study period was selected in accordance with a peak activity episode noted on the emergency department information system database. Participants were identified as per their presenting complaint and discharge diagnosis. The meteorological seasonal patterns, occurring over the same period, were observed in conjunction with patient presentation patterns.

Result: In 2010 the emergency department experienced an increase in the number of asthma related presentations during early November, coinciding with thunderstorm activity, when compared with the same period in 2009. Thunderstorm activity was identified as a related factor in this surge of presentations. The data showed a fourfold increase in asthma presentations during the observed period in 2010 compared to 2009. In 2011, whilst no thunderstorm activity was recorded, heavy rainfall was recorded, as with a sustained rise in respiratory presentations. During the observed period the number of daily respiratory related presentations increased by 13% (n = 135) during 2011.

Discussion and conclusion: Historically, spring sees a greater number of respiratory related presentations associated with a high pollen count and an increase in general airborne allergens. Despite this regional seasonal variation in respiratory presentations, when combined with meteorological events, especially thunderstorm activity, there is the potential for a significant surge in respiratory presentations to emergency departments, potentially leading to an impact on business continuity. Whilst the link between thunderstorm activity during the period of spring to early summer and asthma has been demonstrated in the literature, the impact of this acute respiratory response, on business continuity in regional, metropolitan and tertiary health care centers is not yet well recognized/understood.

Ethics approval: The authors declare that they have no conflict of interest related to the topic of this paper. This study has not been funded nor has it been commissioned. Ethics approval for this paper has been issued through the authors employing organisation (CHCACT HREC ETRN: 1-2014).