How to Detect Paradoxical Pulse on Physical Exam – Step-by-Step Guide for Medical Students

Paradoxical pulse (pulsus paradoxus) is a crucial physical sign in conditions like cardiac tamponade, severe asthma, and COPD—but it’s often missed without proper technique. In this focused clinical video, we walk you through the *exact steps to detect paradoxical pulse at the bedside* using only a *sphygmomanometer and stethoscope* (or Doppler if needed). You’ll learn: ✅ The **definition**: a drop in systolic BP 10 mmHg during inspiration ✅ The **correct exam method**: slow deflation, listening for when Korotkoff sounds *first appear during expiration only*, then become continuous ✅ Common *pitfalls & tips* (e.g., avoiding rapid cuff deflation, patient cooperation, differentiating from irregular rhythms) ✅ The *pathophysiological basis* in cardiac vs. pulmonary causes Perfect for clinical rotations, OSCEs, or cardiology prep—this skill bridges physical diagnosis and critical decision-making! #ParadoxicalPulse #PulsusParadoxus #PhysicalExam #CardiacTamponade #COPD #Asthma #MedicalStudents #ClinicalSkills #Cardiology #MedEd #BedsideMedicine #OSCE