Association between physician specialty and first-attempt intubation success in the emergency department
Abstract
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…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 2,582 participants or records.
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