Two people from Melbourne's west have died, including one 20 year-old man who was forced to wait at least half an hour for an ambulance, after an unprecedented number of people fell acutely sick on Monday evening in what is believed to be a mass incident of "thunderstorm asthma".
Ambulance Victoria was flooded with more than 1900 calls between 6pm and 11pm – more than six times their usual workload – after a storm hit Melbourne shortly before 6pm, prompting a "major disaster response" from emergency services.
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Hospitals deal with 'thunderstorm asthma'
Sunshine Hospital was overwhelmed with respiratory patients on Monday, after more than 1900 people called Ambulance Victoria in what is believed to have been a mass incident of 'thunderstorm asthma'.
At least 600 calls related to respiratory illness with most of them coming from Melbourne's west.
"We essentially had a day's workload within five hours," said Ambulance Victoria's Executive Director Emergency Operations Mick Stephenson.
"We were seeing asthma in people who had not experienced breathing issues before."
Hospitals across Victoria were left reeling, with depleted supplies of asthma spray Ventolin reported, and emergency services battled to respond to calls for help when rain and strong winds churned up pollen, dust and other irritants.
The demand was so great that Ambulance Victoria ran out of ambulances and had to call in police officers, firefighters, non-emergency patient vehicles and field doctors trained for disasters to help with transporting acutely ill patients to hospital. Mr Stephenson said he even worked through the night, treating patients.
Health Minister Jill Hennessy described the event as a "great challenge" for authorities and said private hospitals, including the Cabrini in Malvern, had been opened to public patients to help meet demand.
"There will no doubt be a full review of what occurred last night and what the clinical outcomes were," she said.
"No doubt there will be lessons to learn, there always are in these cases. But every part of our emergency management surge occurred correctly."
- Did you experience a long wait for an ambulance? Contact the reporter.
On Tuesday morning, pharmacists reported a rush on Ventolin and some hospitals were still overflowing with patients.
The Royal Children's Hospital used its Facebook page to warn parents about long waits for care.
"During this busy period, for less urgent care, please consider visiting your local hospital ED or GP to avoid longer than usual wait times. If required, they will refer you to the RCH," the post said.
Royal Children's general medicine director Tom Connell said there had been almost 500 presentations within 24 hours, placing "huge demand" on the hospital's resources.
Dr Connell said the hospital normally received about 220 presentations – children needing treatment – each day, rising to 300 on an exceptional day.
"It's a very rare event for this to occur. The last one in Melbourne was about 2011 and before that was in 1989 – always in November," he said.
There were about 50 admissions to the hospital compared with a normal admission rate of 20 or 30 a day.
Some children were treated for up to 12 hours and then discharged.
Dr Connell said the waiting rooms were still busy as a result of the storm.
Some children who had not had asthma before did suffer attacks because of the weather.
"Most of the parents recognised that their child's symptoms weren't that severe but they were new to them, they had never had them before.
"Therefore it's always a scary time coming into the hospital with your child with an acute respiratory tightening in the chest, which for some would feel like breathing through a straw."
Most parents took their children to the hospital rather than calling an ambulance.
Dr Connell said the hospital's supply of Ventolin did "come close" to a shortage but there were now adequate supplies.
Most children have responded well to treatment and were taken home.
Dr Connell said children were still coming through the emergency department, with 65 there at 8.30am on Tuesday.
A Melbourne doctor who didn't want to be named told Fairfax Media two patients died during the event.
"All of a sudden about 6pm there was a sudden rush of critically ill asthmatics that continued until about 1am," he said.
The doctor, who worked through the night at a Melbourne hospital, said while many staff were called back in to work up to 16 hour shifts, they struggled to keep up.
"The hospitals are all at breaking point," he said.
"A number of hospitals came very close to running out of Ventolin altogether."
The doctor said he heard five or six crews asking for MICA (mobile intensive care ambulances) with no luck, and that was only in one part of Melbourne.
He also heard that two patients in the western suburbs had died, including a 20-year-old.
It is believe MICA units, which are prioritised for people people suffering cardiac arrest, were unable to meet demand.
"There were many critically unwell patients who were not able to access MICA support as they were just unavailable," the doctor said.
Mr Stephenson confirmed two people, including a 20 year old, died while waiting for an ambulance.
He said police had been checking on the welfare of about 12 patients who could not be reached when the ambulance service called them back.
State health commander Paul Holman said in his 40 years as a paramedic he had never seen anything like it.
Mr Holman said it is thought the storm brought with it an increase in irritants, leading to the huge wave of patients suffering from breathing issues.
He said the majority of the patients were so sick they needed to be taken to hospital (rather than being treated at the scene), and at one stage there were 190 people waiting for assistance.
"Every ambulance and ambulance manager was recalled," he said.
"It was an unprecedented night.
"I have never seen the computer dispatch of Melbourne look like it. It was what we call a sea of red."
While Melbourne's air quality has since improved, there are concerns about the ability of hospitals to cope with the surge in demand.
Mr Holman said most hospitals in Melbourne and Geelong had been forced to recall staff.
"Every hospital is basically full," he said.
It is understood a Code Brown was issued at University Hospital Geelong, which means the hospital discharges patients who are ready to go home so the emergency departments can send patients to wards, and make space for incoming people.
Barwon Health, which runs University Hospital Geelong, posted a statement on its Facebook page urging people to seek medical treatment from a GP if their condition was not life-threatening, due to high demand in the emergency department.
Tim Lewis, owner and pharmacist at Southern Cross Amcal Pharmacy, said the pharmacy ran out of Ventolin on Tuesday morning, selling up to 60 inhalers in a few hours. A usual morning might see up to 10 sold.
"I had to go to our other pharmacy to bring up another box of 20 or 30 inhalers," Mr Lewis said.
The last major case of thunderstorm asthma in Melbourne was in 2011, but was not nearly as bad as Monday's event.
The phenomenon is thought to occur when rain or humid weather causes pollen grains to absorb moisture and burst, releasing hundreds of small particles that cause an allergic reaction.
Mr Holman said he was proud of the work of Ambulance Victoria staff and other services for their innovative response to the disaster.
- With Richard Willingham, Neelima Choahan and Deborah Gough
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