• Jason McMullan, Dario Rodriquez, Kimberly Ward Hart, Christopher J Lindsell, Kay Vonderschmidt, Beth Wayne, and Richard Branson.
• Department of Emergency Medicine, University of Cincinnati, 231 Albert Sabin Way ML0769, Cincinnati, OH 45267-0769.
• Mil Med. 2013 Oct 1; 178 (10): 1121-5.

ObjectiveThis study estimates the prevalence of injured patients requiring prehospital supplemental oxygen based on existing recommendations, and determines whether actual use exceeds those recommendations.Patients And MethodsPrehospital oxygen use and continuous peripheral oxygen saturation measurements were prospectively collected on a purposive sample of injured civilians transported to an urban level 1 trauma center by paramedics. Structured chart review determined injury characteristics and outcomes. Supplemental oxygen administration indications were hypoxemia (peripheral oxygen saturation ≤ 90%), hemorrhagic shock (systolic blood pressure < 100 mmHg), or paramedic suspicion of traumatic brain injury.ResultsParamedics enrolled 224/290 screened subjects. Median (range) age was 34 (18-84) years, 48.7% were nonwhite, 75.4% were male, and Injury Severity Score was 5 (1-75). Half (54.5%) were admitted; 36.2% sustained a penetrating injury. None underwent prehospital endotracheal intubation. Hypoxemia occurred in 86 (38.4%), paramedics suspected traumatic brain injury in 22 (9.8%), and 20 (8.9%) were hypotensive. Any indication for supplemental oxygen (107/224 [47.8%, 95%CI 41.3%-54.3%]) and prehospital administration of oxygen (141/224 [62.9%, 95%CI 56.2%-69.2%]) was common. Many (35/141 [24.8%]) received oxygen without indication.ConclusionsOn the basis of current guidelines, less than half of adult trauma patients have an indication for prehospital supplemental oxygen, yet is frequently administered in the absence of clinical indication.Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

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