An adult presents after a motor vehicle collision with a right-sided chest pain and shortness of breath. Vitals show tachycardia and labored breathing. Which action has the highest priority?

• A. Control bleeding with direct pressure
• B. Prepare for immediate transport
• C. Provide oxygen at 15 L/min via nonrebreather mask
• D. Assess airway and breathing

Answer: (C)

Maximizing oxygen delivery is the priority when a trauma patient shows respiratory distress. Signs like tachycardia and labored breathing point to potential hypoxemia, and hypoxia can rapidly lead to organ dysfunction if not addressed immediately. Providing oxygen at high flow through a nonrebreather mask delivers a high FiO2 quickly, supporting oxygen uptake and easing the work of breathing. This directly tackles the most imminent threat to life in this scenario—insufficient oxygen delivery—while you continue to assess airway and breathing and arrange rapid transport. Bleeding control, while important if there’s active exterior bleeding, does not address the immediate problem of compromised oxygenation, and preparing for transport, though essential, should follow promptly after stabilizing oxygenation.