Aerosol generating procedures
Aerosol generating procedures (AGPs) are medical procedures that can result in the release of aerosols from the respiratory tract. The criteria for an AGP are a high risk of aerosol generation and increased risk of transmission (from patients with a known or suspected respiratory infection).
Medical procedures that are considered to be aerosol generating and associated with an increased risk of respiratory transmission are:
- awake* bronchoscopy (including awake tracheal intubation)
- awake* ear, nose, and throat (ENT) airway procedures that involve respiratory suctioning
- awake* upper gastro-intestinal endoscopy
- dental procedures (using high speed or high frequency devices, for example ultrasonic scalers/high speed drills)
- induction of sputum
- respiratory tract suctioning**
- surgery or post-mortem procedures (like high speed cutting / drilling) likely to produce aerosol from the respiratory tract (upper or lower) or sinuses.
- tracheostomy procedures (insertion or removal)
* Awake including "conscious" sedation (excluding anaesthetised patients with secured airway).
** The available evidence relating to respiratory tract suctioning is associated with ventilation. In line with a precautionary approach, open suctioning of the respiratory tract, regardless of association with ventilation, has been incorporated into the current (COVID-19) AGP list. It is the consensus view of the UK IPC cell that only open suctioning beyond the oro-pharynx is currently considered an AGP, and that oral/pharyngeal suctioning is not an AGP.
Source: "National infection prevention and control manual for England", 8 June 2022.
