Oxygen Flow Rate Requirements of Critically Injured Patients

The optimal amount of oxygen to deploy with pararescue personnel for combat casualty care is currently unknown. Our objectives are to determine the proportion of trauma patients requiring supplemental oxygen and the minimal flow rate required by those patients and to evaluate associations between patients injury characteristics and oxygen requirements to identify those most at risk for requiring oxygen. Over 6 months, dedicated study assistants prospectively observed oxygen requirements and supplemental oxygen provision to trauma patients meeting our institution s highest-level trauma team activation criteria during the first 3 hours of emergency care. Results were calculated as proportions or risk ratios with 95 confidence intervals. The mean age of 204 enrolled subjects was 37 years, 161204 were male, median injury severity score was 9 interquartile range 1-21, and 119204 suffered penetrating injuries. The majority of subjects were admitted 141204, 69, with most going directly to the operating room 35141 or intensive care unit 78141 from the emergency department. Penetrating injuries were less likely to require supplemental oxygen respiratory rate 0.65, 95 confidence interval 0.50-0.84. Subjects with Glasgow Coma Scale scores 15, hypotension, abdominal injury abdomen abbreviated injury score 1, and chest injury chest abbreviated injury score 1 were likely to require supplemental oxygen. The majority of never-intubated adult trauma patients can be managed with no or low flow supplemental oxygen. There is significant opportunity to reduce the need for oxygen delivery to the battlespace.