In an elderly patient who is vomiting large amounts of dark, foul-smelling liquids with diffuse colicky abdominal pain and cool, clammy skin, the most appropriate immediate action is to:

• A. Administer oxygen by NRB
• B. Administer oxygen by nasal cannula
• C. Provide supportive care
• D. Give her sips of sports drink

Answer: (B)

The main idea here is to ensure tissues receive enough oxygen when a patient shows signs of poor perfusion or potential shock. Because the patient is breathing on her own, the quickest and safest step is to provide supplemental oxygen at a level that's comfortable and effective for spontaneous breathing. A nasal cannula fits that need: it delivers additional oxygen without the constraints of a tight mask, allows the patient to continue talking and minimizing interference with any vomiting, and is easy to apply promptly. This helps improve the oxygen content in the blood and supports better tissue perfusion as you continue assessment and transport.

Choosing a higher-concentration option like a non-rebreather mask isn’t necessary at this moment unless there are signs of more severe hypoxia or the patient’s oxygen saturation remains low despite the nasal cannula. Simply providing supportive care without actively delivering oxygen wouldn’t address the potential hypoxia. Giving oral sports drinks is unsafe given the large-volume vomiting and risk of aspiration.