New study shows which medical procedures pose COVID-19 risk
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Autopsy, airway suctioning and cardiopulmonary resuscitation are among the list of medical procedures that pose a risk of spreading COVID-19 from a patient to their health-care provider by creating aerosols, according to new research published in the journal BMJ Open Respiratory Research.

The team carried out a systematic review of public health guidelines, research papers and policy documents from around the globe to determine which procedures are classified as aerosol-generating.

Researchers determined the level of agreement across different guidelines for each procedure group, in terms of its classification as aerosol generating, possibly aerosol-generating, or nonaerosol-generating. 128 documents met the inclusion criteria; they contained 1248 mentions of procedures that they categorized into 39 procedure groups.

Procedures classified as aerosol-generating or possibly aerosol-generating by more than 90% of documents included autopsy, surgery/postmortem procedures with high-speed devices, intubation and extubation procedures, bronchoscopy, sputum induction, manual ventilation, airway suctioning, cardiopulmonary resuscitation, tracheostomy and tracheostomy procedures, non-invasive ventilation, high-flow oxygen therapy, breaking closed ventilation systems, nebulised or aerosol therapy, and high frequency oscillatory ventilation.

Disagreements existed between sources on some procedure groups, including oral and dental procedures, upper gastrointestinal endoscopy, thoracic surgery and procedures, and nasopharyngeal and oropharyngeal swabbing.

There is sufficient evidence of agreement across different international guidelines to classify certain procedure groups as aerosol generating. However, some clinically relevant procedures received surprisingly little mention in the source documents.

The authors recommend that (a) clinicians define procedures more clearly and specifically, breaking them down into their constituent components where possible; (b) researchers undertake further studies of aerosolisation during these procedures; and (c) guideline-making and policy-making bodies address a wider range of procedures.

Source: https://bmjopenrespres.bmj.com/content/7/1/e000730
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