Aerosol-Generating Medical Procedures (AGMP)

Precautions Needed for AGMPs

In addition to DROPLET/CONTACT precautions, AGMPs must be performed using AIRBORNE precautions

PPE required for an AGMP includes

  • long sleeved gown

  • gloves

  • a fit tested N95 respirator mask

  • eye protection

  • Intubation and extubation procedures

  • High frequency oscillary ventilation

  • Bronchoscopy and Bronchoalveolar lavage

  • Laryngoscopy

  • Positive pressure ventilation: BIPAP, CPAP

  • High-flow heated humidity oxygen therapy (e.g. AIRVO, OptiFlow) (NOTE: Non-humidified oxygen delivered through nasal prongs and/or non-rebreather masks are NOT an AGMP, regardless of flow rate)

  • Induced sputum

  • CPR with bag valve mask ventilation

  • Tracheostomy insertion/care**/tube change/decannulation (care does not include dressing changes or tie changes)

  • Tracheotomy

  • Nasopharyngeal aspirates, washes and scopes (not a nasopharygeal swab)

  • Autopsies involving respiratory tissues

  • Open airway suctioning

  • Break in closed ventilation system

  • Administration of nebulized medications: Avoid the use of nebulizer if possible. Use of alternatives such as meter-dose inhaler with spacer are preferable

If an AIIR is unavailable, the AGMP should be carried out in a single patient room with the door closed.

  • The door to the room must remain closed

  • Limit the number of HCWs in the room to only those required for the procedure.

  • Ensure HCWs performing or assisting with the AGMP wear appropriate personal protective equipment (PPE).

  • Observe appropriate donning and doffing procedures.

  • N95 masks should be removed AFTER leaving the patient care space and disposed in a waste receptacle.

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