How to measure Pulsus Paradoxus - Step 1: Take a normal manual blood pressure to determine the patient's SBP and remind yourself what their Kortotkoff sounds are like - Step 2: Inflate the BP cuff to higher than their normal SBP - Step 3: Lower the cuff very slowly until you only intermittently hear the Kortotkoff sounds; I often will let the air naturally deflate out of the cuff to get this number. Record the number at this point as Point 1. - Step 4: Continue lowering the cuff until you hear the Kortotkoff sounds coming through at all times (both inspiration and expiration). Record this as Point 2. - Step 5: The difference in mmHg between Point 1 and Point 2 is your pulsus paradoxus value. Typically a value <10mmHg is considered normal (not hemodynamically significant) by Dr. Surbhi Singhal @Surbhi_Singhal2 #Pulsus #Paradoxus #measurement #instructions #cardiology #physicalexam
