How can oxygen therapy be delivered in a resource-limited field setting?

• A. Portable oxygen delivery when available; otherwise optimize ventilation and suction; use nasal cannula or non-rebreather mask if feasible
• B. Oxygen must be delivered via intubation only
• C. Oxygen is unnecessary in the field
• D. Oxygen is delivered only in hospital settings

Answer: (A)

In field care with limited resources, the priority is to get oxygen to the patient using whatever is available, while also ensuring the patient is actually ventilating. The best approach is to use portable oxygen delivery if you have it; this directly increases the amount of oxygen reaching the lungs and tissues without requiring invasive procedures.

If portable oxygen isn’t available or runs out, focus on maximizing ventilation and keeping the airway open. That means using techniques to deliver breaths and clear obstructions—bag-valve-mask ventilation and suction as needed—while positioning the patient to aid breathing.

Noninvasive oxygen delivery options that are feasible in austere settings include a nasal cannula for low to moderate oxygen flow and a non-rebreather mask for higher concentrations, provided you can obtain a good seal and have an adequate oxygen source. These methods deliver supplemental oxygen without the need for intubation.

Intubation is invasive, resource-intensive, and not routinely the first choice in a field setting when the goal is to improve oxygenation; it should be reserved for specific clinical indications and appropriate environments with trained personnel. Oxygen therapy is valuable in the field, not restricted to hospital settings, and should be pursued whenever practical to improve oxygenation.