How is SBP measured?
The SBP measurement technique is based on a pressure cuff around the arm and a photoplethysmographic probe on the fingertip distal to the cuff. When the cuff pressure increases to above SBP, the artery under the cuff collapses and the PPG signal disappears.
How is SBP and DBP measured?
Deflate the cuff further until the pulse disappears: record this reading as the diastolic pressure. Record these two measurements, first the systolic and then the diastolic (e.g., 120/80), in the patient’s notes or chart. Tell the patient the blood pressure reading.
What is a pulsus paradoxus?
Moderate to severe cardiac tamponade, and occasionally constrictive pericarditis, induce hemodynamic changes that enhance the inspiratory fall in systolic blood pressure. This exaggerated drop in systemic blood pressure during inspiration is termed pulsus paradoxus (waveform 1 and waveform 2).
How is blood pressure measured for pulsus paradoxus?
To measure the pulsus paradoxus, patients are often placed in a semirecumbent position; respirations should be normal. The blood pressure cuff is inflated to at least 20 mm Hg above the systolic pressure and slowly deflated until the first Korotkoff sounds are heard only during expiration.
How is pulsus paradoxus diagnosed in cardiac tamponade?
During cardiac tamponade and acute asthma, biventricular interdependence (series and parallel) plays an important role in the inspiratory decrease in left ventricular stroke volume. Early recognition of pulsus paradoxus in the emergency room can help to diagnose rapidly cardiac tamponade.
When to use a pulsus paradoxus tampon?
Pulsus paradoxus can be observed in cardiac tamponade and in conditions where intrathoracic pressure swings are exaggerated or the right ventricle is distended, such as severe acute asthma or exacerbations of chronic obstructive pulmonary disease.
Do you know how to measure a Pulsus?
In medical school, the pulsus was a Step 1 concept that I learned to associate with tamponade. But now that I’ve seen a couple of cases, I think it’s helpful to have a reminder of how to measure a pulsus and create a differential for when you do hear one. First: what causes a pulsus?