Thunderstorm asthma is an uncommon event that can overwhelm healthcare systems and kill patients. It is yet another reason to screen atopic patients for asthma. Those who are sensitized to pollens or outdoor molds and also wheeze with colds are prime candidates for additional evaluation for undiagnosed asthma. Likewise, patients with exercise-induced asthma (who perhaps have more than just this condition) should probably have spirometry to assess for baseline airway hyperreactivity and perhaps exhaled nitric oxide as well. Perhaps for milder asthmatics who are deemed at higher risk, instead of a bronchodilator alone, we should prescribe a combination inhaler with a corticosteroid and a long-acting fast-onset bronchodilator.
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