If you& #39;re unsure what #AGPs are in relation to #SLT practice, or how current UK-wide list was agreed, or why it& #39;s important, read thishttps://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Downwards arrow" aria-label="Emoji: Downwards arrow">

@RCSLT @justinroe @sarahwallaceslt @mmcoffeystamp @gemmaclunie @GovenderRoganie @jemhaines @drjackiem @rachaelmoses @jkfillingham

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The current @PHE_uk list based on this review includes medical and patient care procedures for which there is an accepted & #39;theoretical risk of aerosolisation& #39; such as induction of sputum, which may include a number of different procedures

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Induction of sputum through coughing is an inherent and unpredictable risk which is a core part of the specialist swallowing evaluation performed by #SLT in close contact (<1 metre) with inpatients with #dysphagia (impaired swallowing)

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In people with #dysphagia, reflexive coughing to aspiration is often forceful https://abs.twimg.com/emoji/v2/... draggable="false" alt="➕" title="Heavy plus sign" aria-label="Emoji: Heavy plus sign"> prolonged, and cannot be suppressed https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Rightwards arrow" aria-label="Emoji: Rightwards arrow"> immediate aerosolisation and dispersal of variable-size respiratory droplets which may travel further and remain in the air for longer = inhalation risk

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The official list includes some #AGPs where there is only mixed evidence of aerosolisation or transmission risk demonstrated in some studies, eg NIV, where the & #39;theoretical risk& #39; of aerosol generation is well accepted based on consensus expert opinion

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The risk of airborne transmission in dysphagia-induced coughing has not been previously studied. However, absence of evidence does not mean evidence of absence.

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Expert @RCSLTmembers opinion: it is reasonable to consider #dysphagia assessment to convey a theoretical risk of aerosolisation in same way as other widely accepted medical procedures, and that it should be specified under induction of sputum on official @PHE_uk #AGPs list

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