Aerosol generating procedures in health care, and COVID-19

The findings in this memo are based on rapid searches in the PubMed and Embase databases. One researcher went through all search records, selected and summarised the findings. In the current situation, there is an urgent need for identifying the most important evidence quickly. Hence, we opted for this rapid approach despite an inherent risk of overlooking key evidence or making misguided judgements.

We identified one scoping review, two unsystematic reviews and ten primary studies from the literature search and by manual searching of reference lists.

We did not identify direct evidence on the risk of aerosol related transmission of SARS-CoV-2, but data from similar viruses substantiates that SARS-CoV-2 can be transmitted by aerosol generating procedures in hospitals.

Some studies consistently show that aerosols can be produced during tracheal intubation, tracheotomy, cardiopulmonary resuscitation and manual ventilation. Bronchoscopy, non-invasive ventilation and nebuliser may also produce aerosols, but this evidence is weaker and less consistent. The evidence was uncertain and inconclusive regarding the aerosol generating potential of other procedures.