The Aereosol Debate
In the last few steps, we have explored how infection with SARS‐CoV‐2 and consequent COVID‐19 are a significant cause of mortality and morbidity among patients, healthcare workers and the general population.
The special status of these (AGP)s has been called into question as there has been a higher prevalence of infection observed in healthcare workers caring for COVID‐19 patients using droplets compared with aerosol measures. This so-called ‘aerosol debate’ is of vital importance as it will inform what protection is needed for many airway management interventions going forward.
We invite you to watch a panel discussion on AGPs, specially recorded for the April 2021 run of Airway Matters is available on this link:
In it, Professor Tim Cook moderates a conversation with six leading experts in aerosols field: Dr Tony Pickering, Dr Jules Brown, Professor Euan Tovey, Dr. Nick Wilson, Dr. Bryan Bzdek, and Dr. Gus Hamilton.
During the debate, the panel explores a number of interesting questions:
1) Why has COVID led to an interest in aerosols?
2) What is an aerosol vs what is a droplet? A continuum or two distinct entities?
3) What PPE is needed for each?
4) What precautions beyond PPE are needed?
5) What do the guidelines state and how do they differ?
6) What is and isn’t an AGP and what does this mean in clinical practice?
Dr. Nick Wilson’s study demonstrating high levels of aerosols during coughing and exertional breathing, but not during non-invasive respiratory therapies, is available in the ‘See Also’ section below.
Please do use the comments section to share your thoughts on the role of aerosols and what level of protection you feel comfortable wearing when performing AGPS or treating patients with COVID 19.
The recording is just over an hour, but it is well worth watching it all.
We will now look at the current guidance to try to avoid transmission to healthcare workers through a reduction in droplet transmission and the recommendations for increased protection during aerosol‐generating procedures (AGPs).
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