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If you're unsure what #AGPs are in relation to #SLT practice, or how current UK-wide list was agreed, or why it's important, read this
@RCSLT @justinroe @sarahwallaceslt @mmcoffeystamp @gemmaclunie @GovenderRoganie @jemhaines @drjackiem @rachaelmoses @jkfillingham
1/7 https://twitter.com/DrLucyMM/status/1238813979746750464
@RCSLT @justinroe @sarahwallaceslt @mmcoffeystamp @gemmaclunie @GovenderRoganie @jemhaines @drjackiem @rachaelmoses @jkfillingham
1/7 https://twitter.com/DrLucyMM/status/1238813979746750464
The current @PHE_uk list based on this review includes medical and patient care procedures for which there is an accepted 'theoretical risk of aerosolisation' 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 
prolonged, and cannot be suppressed 
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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prolonged, and cannot be suppressed immediate aerosolisation and dispersal of variable-size respiratory droplets which may travel further and remain in the air for longer = inhalation risk4/7
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 'theoretical risk' 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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