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
a fit tested N95 respirator mask
Intubation and extubation procedures
High frequency oscillary ventilation
Bronchoscopy and Bronchoalveolar lavage
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)
CPR with bag valve mask ventilation
Tracheostomy insertion/care**/tube change/decannulation (care does not include dressing changes or tie changes)
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
Place patient in an airborne infection isolation room (AIIR), sometimes referred to as a negative pressure room, if one is available on the unit.
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.