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Aerosol-generating Procedures (AGP): Protective and Partition Measures

  • By Vasanth Rao Kadam
  • Editorial
  • October-December 2019

Aerosol-generating Procedures (AGP): Protective and Partition MeasuresAirborne or fine droplet spread may be important in transmission of COVID-19 viruses.1 The microdroplets (>5–10 μm) containing infectious particles may remain suspended in the air. It may be dispersed by air currents, and may be inhaled by a person who is in the same room as the source patient during the AGP. Negative pressure ventilation room and frequent air exchanges can reduce the aerosol but availability of negative pressure room or isolated rooms is scarce. Apart from the airway for anesthesia, bronchoscopy, tracheotomy, ear, nose, throat, and sinus procedures may be regarded as AGP which is illustrated in the following table (Table 1).1

During this COVID-19 pandemic, induction of anesthesia and emergence time has never been as challenging time as before. Perhaps the anesthesiologist will be using all measures to prevent and avoid coughing during this time. One of the other challenges is availability of adequate PPE.2 It is better to follow WHO or ISA rationale.2,3Some of the other guidelines reported during SARS also may be useful.4,5 Absence of negative pressure room, lockdown (closed door) post-AGP may be strictly followed for 20 min to minimize the droplets in air. Hence protocols and management guidelines are necessary, which may differ for each institute, based on availability and innovative equipment. Appropriate education among the caregivers will help to reduce fear and any confusion.


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