Characteristics of procedures performed during an emergency medicine residency in Brazil

Abstract

 Objective: To assess the type, the frequency, and the success rates of procedures performed by Brazilian emergency medicine residents. Methods: This prospective observational study analyzed 1,623 procedures performed by 36 emergency medicine residents at a Brazilian residency program from February to December 2023. Residents recorded procedure type, supervision level, success, and complications using a standardized form. Procedural success, defined as completion without major difficulties, was the primary outcome. Success rates and procedural frequency were compared across residency years. Results: Central venous catheterization (28.5%) and orotracheal intubation (27.5%) were the most common procedures, with residents performing a mean of 14 and 13.5 annually, respectively. First-year residents performed most procedures (63.8%), achieving an 87.3% success rate, which improved to 94.6% and 94.0% in the second and third years. Second-year residents had 2.79 times higher odds (95%CI, 1.58-4.94) of successful procedures without difficulty compared to first-years. Rare procedures, including cricothyroidotomy and pericardiocentesis, were performed fewer than 10 times. Conclusion: Brazilian emergency medicine residents gain extensive procedural experience with improving success rates across training years. Addressing gaps in training for rare but critical procedures through simulation-based education is crucial. These findings inform curriculum development to ensure comprehensive procedural competence, particularly in low- and middle-income countries and new emergency medicine training programs.