Primary acidosis if pH <7.38
HCO3 <24 =<unk> 
Always determine if there is another acid/base process occurring
Primary respiratory acidosis if pCO2 > pCO2expected
Primary respiratory alkalosis if pCO2 < pCO2expected
use Winter's formula: PCO2 (expected) = (1.5 x [HCO3–] + 8) ± 2
In acute setting PCO2 should fall by 1 mmHg for every 1 mEq fall in HCO3
Concurrent<unk>  alkalosis if delta-delta > 28
Delta-Delta = (AG - 12) + HCO3
Primary respiratory acidosis if pCO2 > pCO2expected
Primary respiratory alkalosis if pCO2 < pCO2expected
use Winter's formula: PCO2 (expected) = (1.5 x [HCO3–] + 8) ± 2
In acute setting PCO2 should fall by 1 mmHg for every 1 mEq fall in HCO3
Concurrent<unk>  alkalosis if delta-delta > 28
Delta-Delta = (AG - 12) + HCO3
use Winter's formula: PCO2 (expected) = (1.5 x [HCO3–] + 8) ± 2
In acute setting PCO2 should fall by 1 mmHg for every 1 mEq fall in HCO3
Metabolic acidosis
Lactic acidosis
Metabolic alkalosis
Sepsis, shock, liver disease, CO, CN, metformin, methemoglobin
Respiratory acidosis
Short bowel syndrome
Anion gap acidosis
Propylene glycol infusions for lorazepam and phenobarbital