Emergency Medical Technician (EMT) Basic Certification Practice Exam

Which vital sign change may indicate a patient is experiencing pulsus paradoxus?

1. Increased heart rate during inhalation

2. Higher blood pressure during exhalation

3. Decrease in pulse and blood pressure with inhalation

4. No change in vital signs

The correct answer is: Decrease in pulse and blood pressure with inhalation

Pulsus paradoxus is a clinical sign characterized by an exaggerated decrease in blood pressure during inspiration. It typically reflects an underlying issue, such as cardiac tamponade, severe asthma exacerbation, or other conditions that affect the heart and lungs. The correct observation associated with pulsus paradoxus is a decrease in both pulse and blood pressure during inhalation. During deep inhalation, intrathoracic pressure decreases, which can lead to diminished venous return to the heart and subsequently drop in blood pressure. This phenomenon can be detected by noting a significant difference in blood pressure readings between inhalation and exhalation, where the blood pressure will often rise when the patient exhales and drop when they inhale. Understanding this physiological response is crucial for EMTs because it can help identify potentially life-threatening conditions and guide further treatment decisions. It's essential to monitor and accurately interpret vital signs not just in isolation, but in relation to the patient's overall respiratory and cardiovascular status.