Episode 015 | Inhalers, Propellants, and the Push for Lower Carbon Respiratory Care

In this episode of RTMatters, host Patrick Dunne is joined by Dr. Douglas Gardenhire, registered respiratory therapist and Chair of the Respiratory Therapy Program at Georgia State University, for an important discussion on inhaler propellants, greenhouse gas emissions, and the evolving environmental impact of respiratory care. The conversation explores the historical transition from CFC propellants to HFA-134a following the 1987 Montreal Protocol, as well as the upcoming shift to lower global warming potential HFO propellants under the 2016 Kigali Amendment. Dr. Gardenhire discusses the environmental footprint associated with inhaler use, while also examining alternative delivery options such as dry powder inhalers (DPIs), soft mist inhalers (SMIs), and portable compressor-nebulizer systems. Importantly, the episode emphasizes that device transitions must remain patient-centered. Dr. Gardenhire explains why simply switching patients from MDIs to DPIs without evaluating inspiratory flow capability can negatively impact treatment effectiveness and outcomes. The discussion also highlights the critical role respiratory therapists play in patient education, device selection, inhaler technique, and supporting long-term adherence to prescribed controller therapies. This episode offers valuable insight into balancing environmental responsibility with safe, evidence-based respiratory care.