What is an Aerosol Generating Procedure?

How do we protect medical staff from AGPs and the Role of the AGP Calculator?

NHS Air Filtration Supplier since 2000.

What is an Aerosol Generating Procedure?

What risk does this create for healthcare professionals?

The term ‘Aerosol Generating Procedure’ (AGP) is used to describe an activity that may result in the release of small airborne particles (aerosols) or droplets. 

If the patient is suffering from an infectious disease this may be transmitted through the airborne or droplet route during an AGP.

Medical procedures in this category form a lengthy list, which includes tracheal intubation and extubation, manual ventilation, tracheotomy or tracheostomy procedures. AGP should therefore receive extra focus as a higher exposure risk of infection both to patients and staff. Procedures are likely to be carried out in dedicated areas but this cannot always be assured. For example, resuscitation may occur in any clinical area and is potentially an Aerosol Generating Procedure. 

Examples of Aerosol Generating Procedures
Locations where pathogenic aerosols may be generated

What about other Aerosol Generating risks?

Whilst Aerosol Generating Procedures (AGP) are the highest risk, there is a residual level of risk elsewhere in the hospital, in waiting areas, other high footfall areas, or on a hospital ward without dedicated ventilation.

Normal breathing is a baseline level of aerosol generation, while physical exertion will increase output.

If patients arrive in hospital from higher risk environments the probability of them importing infection, asymptomatically, can be higher.

What isn’t often understood is their aerosol outputs can be similar to those arising from higher risk procedures. It is also feasible that non-screened patients may be more likely carriers of infection, thus increasing risk to staff and fellow patients.

There’s an element of uncertainty which can affect morale. ‘We know the risk exists, we just struggle to quantify it in a normal shift.’

What does best practice look like for

Protection Against Aerosol Generating Procedures in Healthcare?

Protections Against AGPs in Hospitals

Guidance on AGP mitigation measures is published by UKHSA on behalf of the Department of Health and Social Care, NHS England and the equivalent bodies of the devolved Nations.

Only staff who are needed to undertake the AGP procedure should be present, wearing airborne PPE/RPE precautions which can be quite intrusive. This forms part of a holistic approach to risk mitigation.

It is our belief that the planned deployment of Air Purification using our Air Sentry System, alongside robust Infection Control Procedures, can reduce risk to near zero. We are able to quantify this reduction in risk, working alongside our NHS clients.

What is an Aerosol Generating Procedure Calculator?

And what is its purpose?

Air Sentry provides an AGP calculator which helps calculate room volumes. We use the term equivalent for air changes as Air Sentry offers a client specified mix of 100% recirculation, through to 100% fresh air. This is shown as eACH.

It then captures the eACH requirements as determined by the guidance referred to above, or as otherwise defined as part of the risk management process. It is important to note that Air Sentry is a system and can include for real air changes, as well as recirculation.

The number of eACH required will be higher in locations where AGP are carried out than they will be on a general ward.  This means the number of units can be geared accordingly, to deliver a whole hospital solution.

Having input the target eACH, the calculator then shows the number of Air Sentry units required for the usage and volume of the room.

AGP outline examples for a General Ward and A&E plus AGP example in an ICU showing a negative pressure environment.

Thoughts & Conclusions

Bespoke Air Filtration Systems for Healthcare.

Air Sentry understand that each hospital and medical environment will have bespoke requirements for Infection Control. The AGP calculator is one tool used to assist determining the Air Filtration requirements. This, alongside 22+ years experience of working with the NHS ensures medical staff and patients have the highest level of protection against airborne risk.

The relationships built-up over the years and our track record mean Air Sentry is often invited to give a professional view on optimising solutions. Our system can offer connection to HVAC, supply fresh filtered air and also offer both positive and negative pressure differential.

Andrew Carnegie, founder reflects;

“We’re a dedicated team and proud to be supporting the NHS through these difficult times. Working collaboratively with NHS staff to protect their welfare and that of their patients is something I’m sure we’ll look back on for many years to come. Meanwhile we’ll continue to supply our systems to meet the growing need and are increasing our production capacity to do so.”

Contact us

Book a no obligation consultation with one of our technicians. 

Hospital wards, Nursing homes, Dental clinics and businesses can return to near pre-pandemic daily routine with proper air purification.

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