Pulsus Paradoxus Video [Stanford Medicine 25]

Visit stanfordmedicine25.stanford.edu to see this video and MUCH more!!!
Educational video on the basics of how to measure pulsus paradoxus in patients suspected of having cardiac tamponade.

[@ike393]

Thanks man! This is legit the only video Ive seen that actually explains WHY this happens and not just the definition of the term. Well done.

[@laurentiu244]

Very good explanation in how to measure pulsus paradoxus .I was looking for that for a long time .Thank you.

[@StanfordMedicine25]

You're welcome!!! Thanks for watching!

[@bananas999]

It was really helpful to hear what this sounds like on a real patient, thank you!

[@JohnnySahn]

explained in such an easy way!! Just wasn't quite getting it from reading. Thank you!!

[@sabin129]

this is probably way too late for you, but anyway: severe asthma --> narrowed airways --> higher resistance during inspiration --> more forceful inspiration to maintain adequate flow rates --> very low intrathoracic pressures --> exaggeration of normal drop in BP during inspiration

[@parulmujoo5682]

Too late? you posted this 8 'years' ago but it's helping now XD. thanks :)

[@BruhMoment-cu4gp]

Thanks!!

[@habibibro6151]

It's still helpful in 2021.

[@christfollower5713]

Still helping in 2022 lol

[@harshgupta8753]

Still helping now...

[@axisgraf]

thanks so much--brief and straight to the point.

[@drrohitkb]

Really Awesome!!
Thanks for making it so short and sweet.

[@flaviamarquesmd]

That was awesome! Thank you a lot for that video and explanation, and specially for the practical example

[@ddaa1991]

Short, informative and complete
Thank you so much

[@kmaruska12]

Thank you! Your videos are helping me survive RN school.

[@lins1217]

awesome explaination!! Read about it and thought I understood, but needed verification to my understanding and this achieved exactly that! Thank you!

[@ahmedmedtech]

that was really good and the editing was nice voice clear instructions amazing

[@fruitsofthespirit7009]

Thank you! I think this will help on my upcoming exam!

[@workaholic888]

Thank you so much!! I couldn't follow my professor when he was explaining this but this really cleared things up!!! :) :) Thank you!!!

[@sepehrhashemi428]

Great explanation and concise! Thanks!

[@StanfordMedicine25]

+Sepehr Hashemi Thanks! More videos coming!

[@MrNOODX]

Thanks for your effort really appreciate it

[@lauramed6654]

This was a very clear explanation thankyou!

[@sivaranjaniravilatha8949]

awesome examination, thank god atleast 1 video tells how to examine using BP cuff !

[@ChrisNP87]

This is great! Thank you!!

[@laurencehaslam839]

Excellent presentation Thanks

[@na1ta9li9a3]

thanks! great video! short and to the point!

[@StanfordMedicine25]

Thanks for your comment!

[@shameldiesel]

Man .. this is an awesome video .. thank you

[@gregoireanglade2010]

Great Explanations!!!

[@prashantkumar-yc7fp]

Thanks for the video!!!

[@MrMike00722]

thanks guys! I feel like this is a concept that is poorly taught in med school. I like the animation.

[@samratspeaks]

Awesome!!!

[@bbily123]

Very clearly explained, thanks!

[@skb2840]

Can you please make a short video on pulsus paradoxus. So common in EMED but at the same time often missed.

[@j_ek7243]

Very good 👍 thank you!!

[@kudakwashesimba3517]

I like it. Thanks good work

[@hamsterchks85]

Thank you!!

[@dewankudrat5673]

Very nice

[@RoShep112008]

Extremely helpful- thank you!

[@DocMcSleepy]

Great video! Thanks for the clear explanation.

[@medicinestudent123]

@0:57 "all you need is a stestoscope" love his intonation

[@snowangel00187]

thank you so much.

[@StanfordMedicine25]

Thank you!

[@sabin129]

Thanks! Awesome video. Very helpful.
Nitpick: at 1:05 Korotkoff, not "Kortakoff"

[@djinnahwell]

i finaly knew how to measure pp.
thaks so much

[@unknownperson-pt7bf]

Now i get it thanks 😊

[@krunalkapure]

thanks

[@wv9873]

Can you please explain what the kortokoff sounds correlate to and why we follow them in tamponade?

[@mansoorisgreat]

thanx..

[@nazzadabest]

Why do you get pulsus paradosus in severe asthma? Is the intrathoracic pressure to high even on inspiration? Can someone explain this thanks

[@Forrestwilliam]

Nice job! Munden Interactive

[@hydrohasspoken6227]

I noted pulsus alternans too

[@mig2182]

wooww niceeee !!!! thanks

[@bella1207ful]

Very good! Thank you. I'd like to see your explanation using Arterial Pressure Monitoring waveform analysis...karotkoff sounds aren't typically used in the inpatient setting.

[@StanfordMedicine25]

Either will work the same. Art lines are less common of course as they are used only in CCU's and ICU's so we use the BP cuffs since more common. Maybe you meant pulse ox waveform. That would work as well and we often use but again only with patients connected to that.

[@bella1207ful]

Yes, having both would be ideal. Assessing for tamponade is what I was looking for, a visual of the waveforms.

[@bella1207ful]

Thanks again for the great videos.

[@inluvwitgod2]

Thank You Thank You Thank You!

[@underdoggys]

The test is made during normal breathing ?

[@uatk]

Thanks : )

[@SmithMDable]

ohhh thanks!!!!

[@imjennyyeh]

Why is pulsus paradoxus also seen in asthma sleep apnea and croup

[@atlive1]

I like the voice

[@TheAtheist22]

In tamponade the pressure is transmitted at the septum but not the ventricular wall??The ventricle is a compartment filled with fluid, an increase in pressure at any point will be transmitted through out.

[@thyepengngo255]

Hello! May I request for permission to use it in classroom for the nursing students? Thank you.

[@susheelsharma95]

Thumbs up👍

[@SAnode1]

So can you explain more about what those BP readings actually meant? You measured the systolic BP and then during inspiration you continued to look for the systolic BP while slowly deflating the BP cuff? Could not get that part.

[@kbbluesgreens74]

While the blood pressure cuff is slowly being deflated listen for the heart sounds, watch the blood pressure gauge, and watch the patient to the left looking specifically for what happens when he's inspiring. The first heart sounds (Korotkoff sounds) are heard when the pressure exerted by the cuff equals the patient's systolic blood pressure. For this guy in the video its at ~118mmHg. However at and slightly below this pressure you'll notice when he inspires (you can see him breathing in and out on the left side of the gauge) the heart sounds stop, and then resume when he breathes out. This indicates that when he's inspiring the pressure exerted by the cuff is higher than his inspiratory systolic blood pressure (i.e. his systolic blood pressure is dropping when he breathes in). Continue to watch the video and look for when the heart sounds NO LONGER disappear with inspiration. This happens at ~92mmHg, and indicates his inspiratory systolic pressure is now equal to the cuff pressure (i.e. you've discovered his inspiratory systolic blood pressure).
Overall, this indicates the patient's systolic blood pressure is drops from 118mmHg to 92mmHg when he inspires - this fits the definition of pulsus paradoxus because P.P. is defined as a "Systolic pressure drop greater than 10mmHg with inspiration" (the patient's blood pressure drop with inspiration is 118mmHg-92mmHg= 26mmHg)

[@Shurshalka83]

Thank you very much for such a detailed explanation!!!

[@boggycocktail2545]

​@@kbbluesgreens74 thanks, this was wholesome!!

[@ginjeda]

This could probably use an update, with better quality footage and graphics. Just my two cents

[@drs6530]

من طالب مسحول و عنده عملي بعد 4 ساعات 😢😢

[@aykau777]

0:07