Aerosol-generating procedure

1. Aerosol-generating procedure

An aerosol-generating procedure (AGP) is a medical or dental procedure that can result in the release of airborne particles (aerosols) from the respiratory tract. These procedures are of particular concern in the context of infectious diseases, such as COVID-19, where aerosols may contain pathogens that can be transmitted through the air.

Overview

Aerosol-generating procedures are significant in healthcare settings because they can increase the risk of airborne transmission of infectious agents. During these procedures, small droplets and particles are generated, which can remain suspended in the air for extended periods and be inhaled by healthcare workers or other patients.

Common Aerosol-generating Procedures

Some common aerosol-generating procedures include:

• Intubation and extubation
• Bronchoscopy
• Cardiopulmonary resuscitation (CPR)
• Non-invasive ventilation (e.g., CPAP, BiPAP)
• Sputum induction
• Open suctioning of airways
• Dental procedures involving high-speed devices

Risks and Precautions

Healthcare workers performing AGPs are at increased risk of exposure to airborne pathogens. To mitigate these risks, several precautions are recommended:

• Use of appropriate personal protective equipment (PPE), including N95 respirators or higher-level protection, face shields, gowns, and gloves.
• Performing procedures in negative pressure rooms when possible.
• Minimizing the number of personnel present during the procedure.
• Implementing engineering controls such as high-efficiency particulate air (HEPA) filtration and proper ventilation.

Impact of COVID-19

The COVID-19 pandemic has heightened awareness of the risks associated with AGPs. The SARS-CoV-2 virus, responsible for COVID-19, can be transmitted via aerosols, making AGPs particularly concerning. Guidelines from organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) emphasize the importance of protective measures during AGPs to prevent the spread of COVID-19.

Research and Developments

Ongoing research aims to better understand the dynamics of aerosol generation and transmission during medical procedures. Innovations in PPE, ventilation systems, and procedural techniques continue to evolve to enhance safety for healthcare workers and patients.

Also see

• Airborne transmission
• Infection control
• Personal protective equipment
• Respiratory protection