Tutorial presented by Luke Morgan, 5th Year Medical Student

In this tutorial, Luke discusses:

1. Making the switch, including the adage ‘Switch at 6’
2. If a child is not suitable for the switch
3. Addressing other safety concerns

There is a significant difference between the carbon footprint of a Metered Dose Inhaler versus a Dry Powder Inhaler;

• A Ventolin Evohaler (MDI) has a CO₂ equivalence of 25kg
• A Ventolin Accuhaler (DPI) has a CO₂ equivalence of <1kg

Because of this, the recommendation is to switch to a Dry Powder Inhaler whenever possible. In adults, this switch should be straightforward, but in children this is more complicated by a number of factors, including licensing and inspiratory flow rates. For this reason, the phrase ‘Switch at 6‘ has been coined; any patient over 6 years should be considered for the switch. An assessment of the child’s disease control is important when making the switch; any carbon savings would be lost completely if the child had more admissions into hospital because of uncontrolled asthma.

If a child isn’t suitable for the switch to a DPI, there are other things that can be done to lower their carbon footprint, including switching to a Metered Dose Inhaler with a lower carbon footprint;

• A Ventolin Evohaler (MDI) has a CO₂ equivalence of 25kg
• A Salamol Evohaler (MDI) has a CO₂ equivalence of 10kg

and this switch can be considered for every patient who is not suitable for the switch to a MDI.