A clinician unsuccessfully tried to take the pulse of a patient who is suffering from an asthma attack in the ER
The patient's breath sounds are diminished to absent bilaterally with a BP of 110 mm Hg systolic and 90 mm Hg diastolic. What can be concluded about this patient's condition?
1. Abdominal paradox is present.
2. Lung hyperinflation is present.
3. Pulsus paradoxus is present.
4. Pulse pressure is greater than 30 mm Hg.
a. 2 and 3 only
b. 1 and 2 only
c. 2 only
d. 1, 3, and 4 only
ANS: A
When the pulse pressure is less than 30 mm Hg during spontaneous inhalation, the peripheral pulse is difficult to detect, which is called pulsus paradoxus, or paradoxical pulse. Pulsus para-doxus is the consequence of lung hyperinflation experienced during a severe asthma attack or status asthmaticus.
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