If you have breathing difficulties during a thunderstorm, you should take your reliever medication, but if symptoms persist - go straight to the Emergency Department of your local hospital.
Asthma Australia has found that a large proportion of people who have wheezing and sneezing or other breathing symptoms during the spring thunderstorm season do not realise they are sensitive to pollens. Also they often do not regard themselves as having asthma and therefore have not consulted their doctor for an Asthma Action Plan.
Many people moving to rural NSW may not have been previously exposed to this combination of environmental conditions and have never experienced the symptoms of asthma. This includes an increasing transient population, such as defence personnel, University students and itinerant workers.
Preventative action
There are several actions that can help protect against thunderstorm asthma:
- avoiding outdoor activities during thunderstorms, particularly those involving physical activity when breathing is increased
- ensuring that home evaporative air conditioning has water flow to the pads and windows are slightly opened to maintain fresh filtered and cool air flow. However, with refrigerated air conditioning, windows and external doors should be closed and in the car, the air-conditioner should be switched to recycle mode
- having a current Asthma Action Plan
- taking prescribed asthma medications as directed, including ready access to reliever medications
Asthma medications
- Preventers - make the airways less sensitive to triggers, reduce the inflammation and swelling inside the airways and dry up the mucus. It may take a few weeks to reach their optimal effect and usually need to be taken daily, even when feeling well
- Relievers - provide relief from asthma symptoms within minutes. They relax the muscles in the wall of the airways for up to four hours, allowing air to more easily move through the airways. In some acute emergency cases, patients me be prescribed short courses of oral (not inhaled) corticosteroids in tablet or liquid form to minimise symptoms.
- Symptom controllers - (also called long-acting relievers) help to relax the muscles around the airways for up to 12 hours. They are taken every day and are only prescribed for people who are taking regular inhaled 'steroid' preventers
- Combination medications – combination of a preventer with a symptom controller in the same delivery device
Delivery devices
Most asthma medications are inhaled via either an aerosol inhaler (puffer) or dry powder inhaler. Most people use inhaled asthma medication because the medication goes directly and quickly to the lungs and smaller doses can be given so there are fewer side effects.
Use of a spacer device (such as the one in the image) optimises delivery of the drug dose to the smaller airways (and limits deposition in the mouth and throat). Some spacers are disposable (and are not designed for re-use).
Nebulisers are rarely used these days due to the need for extensive cleaning and maintenance.
Asthma Australia provides several short videos on specific techniques for each type of inhaler device, including use of spacers, and facemasks.
Asthma first aid
- Sit the person upright and give reassurance. Do not leave the person alone.
- Without delay give 4 puffs of a reliever (Airomir, Asmol, Epaq or Ventolin). The medication is best given one puff at a time via a spacer device if available. Ask the person to take 4 breaths from the spacer after each puff of medication. A Bricanyl Turbuhaler may be used in first aid treatment if a puffer and spacer is not available
- Wait 4 minutes. If little or no improvement repeat step 2 and wait a further 4 minutes.
- If there is still no improvement call an ambulance (Dial 000).
Continuously repeat steps 2 and 3 while waiting for the ambulance.
You can download the Asthma First Aid App to access the asthma first aid steps wherever you are.
Where to get further help on asthma
There have been some recent changes to asthma medication and treatment options in Australia. It is important that you ask your doctor about these changes at your next asthma review to know your asthma treatment options.
Resources
The Wagga Asthma and COPD Collaborative is a group of health professionals and consumer representatives who promote awareness of asthma and coordinate the pollen counts and asthma alerts for the Wagga Wagga region when the thunderstorm asthma risk is high.
