Just the use of noninvasive ventilation in the Emergency Department has numerous articles of documented data over the past several decades. The survival and avoidance of intubation are well documented even if NIV was not started in the field. Those in EMS should not disregard this data even if it was not done in an ambulance. The way to change is to see what others are doing and see if it can be applied in the field or at least understand the reasons behind it with the disease process.
ABGs are a great way to determine CO2 retention. Statistically very few COPD patients are retainers. There are other points such as fatique and deadspace which will determine endpoint for need of additional support.
You might ask the lab to pull up the number of ABGs drawn in the ED. You might be surprised at the number done. Alot of patients in the ED do end up in the ICU. There are alot of reasons to draw them besides CO2. If used appropriately by someone who understands the numbers and how to correlate them to other data, ABGs should not be discounted as just numbers.
