North Carolina EMT State Practice Exam

Which of the following is NOT part of the triad of signs commonly seen with increased ICP?

1. Increased systolic blood pressure

2. Decreased pulse rate

3. Irregular respirations

4. Increased heart rate

The correct answer is: Increased heart rate

The triad of signs commonly associated with increased intracranial pressure (ICP) is known as Cushing's triad, which typically includes hypertension (increased blood pressure), bradycardia (decreased heart rate), and irregular respirations. When intracranial pressure rises, the body responds through these vital signs. Increased systolic blood pressure occurs as a compensatory mechanism to ensure adequate cerebral perfusion. The decrease in pulse rate, or bradycardia, is a response often observed because of increased pressure on the brain which can affect the vagus nerve and lead to a slowing heart rate. Irregular respirations can also result from the impact on the brainstem, which controls respiratory patterns. In contrast, an increased heart rate is not part of this triad and can actually be indicative of other issues, such as shock or anxiety. Therefore, it is not associated with increased ICP, making it the option that does not belong in the context of Cushing's triad.