What oxygen delivery method is preferred for a casualty with suspected thoracic injury in the field?

• A. Low-flow oxygen via nasal cannula at 2 L/min
• B. High-flow oxygen via mask with a good seal; monitor and adjust to maintain oxygenation.
• C. Room air with continuous pulse oximetry only
• D. Nebulized oxygen therapy via nebulizer

Answer: (B)

In a casualty with suspected thoracic injury, the priority is to maximize oxygen delivery quickly to prevent or treat hypoxemia while you continue assessment and treatment. Low-flow oxygen via a nasal cannula provides only a modest increase in inspiratory oxygen and may not meet the needs of a compromised chest. Providing oxygen while the patient is on room air with only continuous pulse oximetry doesn’t actively raise oxygen levels, so it won’t reliably support ventilation in this scenario. Nebulized oxygen therapy isn’t a rapid or reliable method to achieve high FiO2 in trauma care, and it can delay more effective delivery. The most effective approach in the field is delivering high-concentration oxygen through a mask that seals well, such as a non-rebreather mask, and adjusting the flow to keep oxygenation adequate. This method delivers the highest FiO2 quickly and supports the patient’s oxygen status while you monitor and manage the injury.