Within the climate emergency, the use of MDI (metered dose inhalers) contributes to the increase in atmospheric CO2. These medications are widely used in patients with respiratory conditions, but the type of inhaler should be changed to dry powder or fine mist to improve environmental sustainability.1. Establish a clinical and therapeutic profile of respiratory patients treated in the emergency department. 2. Determine the number of MDI inhalers both upon admission and upon discharge from the hospital.Medical records of patients treated in the emergency department between January 1 and April 30 ,2025 who presented with exacerbation of bronchial asthma or chronic obstructive pulmonary disease (COPD) were reviewed. Demographic variables (age, sex), clinical variables (comorbidities), and treatments used were obtained. The data were processed using the SPPS program.A total of 218 patients were enrolled, of whom 89 had asthma and 129 had COPD. In the asthma group, 57.3% were women, while in the COPD group, 81.4% were men. The average age in the asthma group was 51.2 ± 10.2, while in the COPD group it was 74.6 ± 18.4 years. Main comorbidities in both groups were high blood pressure, diabetes mellitus and dyslipidemia. Total number of MDI inhalers in the asthma group prior to admission was 78 (ratio 0.87), while in the COPD group it was 140 (ratio 1.08). At discharge, the number was 90 (ratio 1.01) in the asthma group and 176 (ratio 1.36) in the COPD group. Rescue MDI use was +85.7% for salbutamol and +76.9% for ipratropium in the asthma group, and +37.14% for salbutamol and +23.53% for ipratropium in the COPD group.Use of MDI devices whose propellant gases contribute to the increase in environmental CO2 is widespread in the management of respiratory patients worldwide, and their widespread use has grown exponentially in recent decades. Use is even greater when it comes to rescue medication.1. There is a high proportion of MDIs in the patients studied. 2. The use of MDIs is even greater upon hospital discharge and when used as rescue medication. 3. The use of DPI and SMI devices should be promoted.