If your organisation is performing aerosol generating procedures, we are asking for you to let us know by filling in this short form here.

What are Aerosol generating procedures:

Current national PPE guidance states that enhanced respiratory PPE is indicated for health and social care workers performing or assisting in procedures that generate aerosols,  whether the client has COVID symptoms or not.

During these aerosol generating procedures (AGPs) a long-sleeved disposable fluid repellent gown (covering the arms and body) or disposable fluid repellent coveralls, a filtering face piece class 3 (FFP3) respirator (not fluid resistant surgical mask), a full-face shield or visor and gloves are recommended for use by staff. Where an AGP is a single procedure, PPE is to be single use, with disposal after each patient contact or procedure appropriate.

The following procedures are currently considered to be potentially infectious AGPs for COVID-19:

  • intubation, extubation and related procedures, for example, manual ventilation and open suctioning of the respiratory tract (including the upper respiratory tract)
  • tracheotomy or tracheostomy procedures (insertion or open suctioning or removal)
  • non-invasive ventilation (NIV); Bi-level Positive Airway Pressure Ventilation (BiPAP) and Continuous Positive Airway Pressure Ventilation (CPAP) (eg. Via Nippy machines or sleep apnea machines)
  • high flow nasal oxygen (HFNO)

For patients with possible or confirmed COVID-19, any of these potentially infectious AGPs should only be carried out when essential. Where possible, these procedures should be carried out in a single room with the doors shut. Only those staff who are needed to undertake the procedure should be present.

Administration of a nebuliser is NOT considered to be an AGP as it is generating an aerosol from the medication rather that the client’s secretions

Filtering face piece class 3 (FFP3) respirators

Respirators are used to prevent inhalation of small airborne particles arising from AGPs.

All respirators should:

  • be well fitted, covering both nose and mouth
  • not be allowed to dangle around the neck of the wearer after or between each use
  • not be touched once put on
  • be removed outside the client room or cohort area

FFP3 respirators filter at least 99% of airborne particles. The HSE states that all staff who are required to wear an FFP3 respirator must be fit tested for the relevant model to ensure an adequate seal or fit (according to the manufacturers’ guidance). Fit checking (according to the manufacturers’ guidance) is necessary when a respirator is donned to ensure an adequate seal has been achieved.

Further information regarding fitting and fit checking of respirators can be found on the Health and Safety Executive website.

It is also important to ensure that facial hair does not cross the respirator sealing surface and if the respirator has an exhalation valve, hair within the sealed mask area should not impinge upon or contact the valve. See the Facial hair and FFP3 respirators guide.

The respirator should be discarded and replaced and NOT be subject to continued use in any of the following circumstances:

  • is damaged
  • is soiled (for example, with secretions, body fluids)
  • is damp
  • facial seal is compromised
  • is uncomfortable
  • is difficult to breathe through

The manufacturers’ guidance should be followed in regard to the maximum duration of use.

For information on how to put on, and take off enhanced respiratory PPE used for AGPS, please see the following guidance https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-aerosol-generating-procedures

Please let us know the following information so that HCPA and the CCGs can offer you support where needed:

» Fill in our formDeadline for form submissions is Thursday 21st May