Which of the following actions is the first priority for a paramedic attending to an elderly female patient who is lethargic and has a spo2 of 92%?

Administering high flow oxygen is the first priority for a paramedic in this scenario because the patient's oxygen saturation level of 92% indicates that she is experiencing hypoxemia, which means her blood oxygen level is lower than the normal range. Oxygen is critical for maintaining cellular metabolism and overall function, particularly in an elderly patient who may have underlying conditions affecting respiratory efficiency or circulatory stability.

In this case, providing immediate supplemental oxygen can help improve the oxygen levels in the patient's blood, alleviating any hypoxic effects on vital organs. When patients present with lethargy and low oxygen saturation, they may be at risk for significant deterioration, and high-flow oxygen can provide quick support to stabilize their condition.

Other actions, such as administering oral glucose, attaching a cardiac monitor, or performing a blood glucose test, could also be important depending on the patient's overall clinical picture. However, addressing the immediate threat of inadequate oxygenation takes precedence to prevent further complications. Thus, initiating high flow oxygen therapy is the most critical first step in the management of this patient.