The over simplified teaching of ABGs do an injustice to the bedside clinical health professional.
Many focus on the disease process of "COPD" without considering the many other pulmonary and non-pulmonary disease processes which are interconnected.
Treatment is not going to depend solely on the ABG. The anion and OSM gap must be considered when it comes to acidosis. The other lab data can also help determine if the results of the ABG are an early or later stage and determine the path of care. Sometimes a patient with a low pH can avoid intubation based on this data. We've also extubated patients post operatively with a less than ideal ABG by understanding the other data used for differential diagnoses.
Here's a little more detailed ABG interpretation.
For Respiratory Acidosis you may need to determine if it is hypoventilation from:
(taken from the above articles)
1. Chronic obstructive pulmonary disease
2. Neuromuscular diseases - e.g. Guillain-Barre syndrome, Myasthenia Gravis, Muscular Dystrophy
3. CNS depression - e.g. drugs (opiates, barbiturates), neurological disorders (trauma, brainstem disorders)
Or failure due to V/Q mismatching and hypoemia.
2. Pulmonary edema
4. Pleural effusion
Some of these you can help correct or influence as a bedside clinician. The support (O2, NIV, ventilator, positioning
) offered will depend on the determined underlying disease process and the clinical symptoms determining the amount of "rescue" required.
Pulmonary Emboli is also another consideration but the ABG will probably appear as "hyperventilation" initially.