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Freitas, Ana Paula

Mayo Clinic

Department of Emergency Medicine, Hospital de Pronto Socorro, Porto Alegre, Rio Grande Do Sul

Citations 1

Association between physician specialty and first-attempt intubation success in the emergency department
Besen, Bruno Adler Maccagnan Pinheiro , Carvalho, Julia M. Dorn de, Pedrollo, Daniel, Nogueira, Caio Goncalves, Figueiredo, Natalia Mansur P., Martins, Danilo, Baumgratz, Thiago Dias , Bergesch, Bruno, Costa, Diogo , Colleoni, Osmar , Zanettini, Juliana, Freitas, Ana Paula, Moreira, Nicole Pinheiro, Gaspar, Patrícia Lopes, Tambelli, Renato, Costa, Maria Cristina , Silveira, Samara, Correia, Wilsterman, Maria, Rafael Garcia de, Filho, Ubirajara A. Vinholes, Weber, Andre P., Castro, Vinicius da Silva, Dornelles, Carlos Fernando Drumond, Tabach, Barbara S., Stanzani, Gabriela , Gava, Thiago F., Silva, Gabriella Rennisy de Sousa , Oliveira, Giovanna Cardoso de, Bellolio, Fernanda , Alencar, Júlio César Garcia de , Maia, Ian Ward Abdalla , Investigators, on behalf of BARCO, Oliveira J E Silva, Lucas , Mullan, Aidan, Sandefur, Benjamin J. , Ward A Maia, Ian, Bellolio, M Fernanda , Besen, Bruno Amp , Silva, Lucas Oliveira J. e , Hellmann, Rafael von , Carvalho, Julia M. Dorn de, Hajjar, Ludhmila Abrahão , Miranda, Carlos Henrique , Tambelli, Renato, Guimarães, Hélio Penna , Mullan, Aidan F. , Oliveira, Giovanna Cardoso de, Investigators, on behalf of BARCO

European Journal of Emergency Medicine | September 10, 2025 | Volume: 32 | Issue: 6 | Pages: 430-436

10.1097/mej.0000000000001276 Get It

Background and importance Emergency airway management in the emergency department (ED) is a high-risk procedure associated with patient outcomes. First-attempt success is a widely recognized quality metric, as multiple attempts are associated with an increased risk of peri-intubation complications. In Brazil, where emergency medicine is a recently established specialty, many ED are staffed by physicians without formal emergency medicine training. The association between emergency medicine training and intubation outcomes in this setting has not been well characterized. Objective To assess the association of physician specialty with first-attempt success and immediate peri-intubation complications in Brazilian EDs. Design Secondary analysis of a multicenter, prospective cohort study from the Brazilian Airway Registry Cooperation. Setting and participants This study included adult patients who underwent tracheal intubation in EDs between March 2022 and April 2024. Patients were excluded if the intubation occurred outside the ED, during cardiopulmonary resuscitation, or for elective procedures. Intubations performed by medical students were also excluded. Physicians were categorized by specialty as emergency medicine or nonemergency medicine. Outcome measures and analysis The primary outcome was first-attempt success; secondary outcomes included peri-intubation complications (severe hypoxemia, hemodynamic instability, and cardiac arrest). Multivariable logistic regression was used to assess the association between physician specialty and outcomes. Main results Among 2582 patients, 1087 (42.1%) were intubated by emergency physicians and 1495 (57.9%) by other physicians (mainly internal medicine and surgery). Intubations by emergency physicians were associated with a higher rate of first-attempt success [80.4 vs. 70.9%, adjusted odds ratio [aOR]: 1.63, 95% confidence interval (CI): 1.34–1.97]. There was also a higher odds of intubations without major complications (aOR: 1.20, 95% CI: 1.01–1.42). Conclusion In this study, there was a higher rate of first-attempt success in intubations performed by board-certified emergency physicians compared with other physicians working in Brazilian EDs.