Pulse Paradox

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Gday everyone:nurse:Just wanna ask a quick question....Could any of you please tell me how to properly do/take a pulse paradox of a pt. Any tips/advice will be highly appreciated...Thanks heaps in advance:nurse:

Specializes in ED, ICU, PACU.

http://clinicalmedicineupdate.blogspot.com/2006/04/review-article-pulsus.html

Easiest way is to take the radial pulse and see if here is a difference during inspiration. The link goes into the technical way to do it.

Specializes in Med Surg/Tele/ER.

thanks so much for the info!I'm currently on my days off, but I will surely have more an idea about the pulses parodoxus...:bowingpur

From Harrison's principles of internal medicine...

"In pulsus paradoxus, the decrease in systolic arterial pressure that normally accompanies the reduction in arterial pulse amplitude during inspiration is accentuated. In patient's with pericardial tamponade, airway obstruction, or superior vena cava obstruction, the decrease in arterial systolic pressure frequently exceeds the normal decrease of 10 mmHg and the peripheral pulse may disappear completely with inspiration."

so basically the systolic pressure/pulse amplitude decreases more than usual on inspiration and can be due to a life threatening condition. I suppose you could use an arterial line waveform if you want to be precise or just palpate, but i think the biggest thing to remember is to look at the patient. Since this can be caused by life threatening problems they will or will eventually show other signs and symptoms that will point you in the right direction. Hope this helps...

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