Aerosol generating procedures

Aerosol generating procedures (AGPs) are medical procedures that can result in the release of aerosols from the respiratory tract. The criteria for an AGP are a high risk of aerosol generation and increased risk of transmission (from patients with a known or suspected respiratory infection).

The list of medical procedures that are considered to be aerosol generating and associated with an increased risk of respiratory transmission is:

  • awake* bronchoscopy (including awake tracheal intubation)
  • awake* ear, nose, and throat (ENT) airway procedures that involve respiratory suctioning
  • awake* upper gastro-intestinal endoscopy
  • dental procedures (using high speed or high frequency devices, for example ultrasonic scalers/high speed drills
  • induction of sputum
  • respiratory tract suctioning**
  • surgery or post-mortem procedures (like high speed cutting / drilling) likely to produce aerosol from the respiratory tract (upper or lower) or sinuses.
  • tracheostomy procedures (insertion or removal).

*Awake including ‘conscious’ sedation (excluding anaesthetised patients with secured airway)

** The available evidence relating to respiratory tract suctioning is associated with ventilation. In line with a precautionary approach, open suctioning of the respiratory tract regardless of association with ventilation has been incorporated into the current (COVID-19) AGP list. It is the consensus view of the UK IPC cell that only open suctioning beyond the oro-pharynx is currently considered an AGP, that is oral/pharyngeal suctioning is not an AGP.

Manual contents

Chapter 1: Standard infection control precautions (SICPs)

Chapter 2: Transmission based precautions (TBPs)


Download a PDF copy of the National infection prevention and control manual for England