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Guidelines
AGMPs

AGMPs

General Information

Aerosol-generating medical procedures (AGMPs) include procedures carried out on a patient that can induce the production of aerosols.

During an AGMP in a patient with suspected or confirmed COVID-19, all staff require gown, fit-tested N95 respirator, facial/eye protection and gloves.

AGMP List

  • Intubation
  • Extubation
  • Code blue
  • Non-invasive ventilation (e.g., CPAP, BiPAP)
  • Manual ventilation
  • High-flow oxygen (e.g. AIRVO, Optiflow)
  • Open suctioning
  • Bronchoscopy
  • Induced sputum
  • Chest tube insertion for trauma or tension pneumothorax
  • Autopsy
  • Nasopharyngoscopy
  • Oral, pharyngeal, transphenoidal and airway surgeries (including thoracic surgery and tracheostomy insertion)
  • Breath stacking
  • Cough assist device
  • High frequency ventilation

The following situations require risk stratification of the patient. In intermediate or high risk of COVID-19, treat as AGMP.

  • Ventilator circuit disconnect (assuming filter in place)
  • Gastroscopy
  • ERCP
  • Transesophageal echocardiogram (TEE)
  • Nebulization
  • Collection of nasopharyngeal or throat swab
  • Chest tube removal (unless in setting or emergent insertion for ruptured lung/pneumothorax)
  • Coughing
  • Oral suctioning
  • Oral hygiene
  • Colonoscopy
  • Laparoscopy (GI/pelvic)
  • Cardiac stress tests
  • Caesarian section or vaginal delivery of baby done with epidural
  • Any procedure done with regional anesthesia
  • Nasogastric/nasojejunal tube/gastrostomy/gastrojejunostomy/jejunostomy tube insertion
  • Bronchial artery embolization
  • Chest physiotherapy (outside of breath stacking, cough assist or deep suctioning)
  • Supplemental O2 up to 15L/min - can include nonrebreather and venturi mask delivery
  • Compression only CPR
  • AED use