Which of the following findings are indicative of increasing intracranial pressure?

The correct answers are C. Bradycardia and E. Widening pulse pressure.

This question is based on recognizing increased intracranial pressure (ICP), specifically components of Cushing’s reflex (Cushing’s triad).

Cushing’s triad includes:

Bradycardia

Hypertension with widening pulse pressure

Irregular respirations

Why C is correct (Bradycardia):

As ICP increases, pressure on the brainstem leads to:

Vagal stimulation

Slowing of the heart rate

NREMT-aligned guidance:

“Bradycardia is a late sign of increased intracranial pressure.”

Why E is correct (Widening pulse pressure):

ICP causes:

Increased systolic pressure

Decreased diastolic pressure

This results in a widening pulse pressure, a hallmark of worsening ICP.

Guidelines state:

“Hypertension with widening pulse pressure is associated with increased intracranial pressure.”

Why the other options are incorrect:

A. Tachypnea: Early stress response; ICP causes irregular, not simply rapid breathing.

B. Hypotension: Opposite of ICP findings; suggests shock.

D. Muffled heart sounds: Associated with cardiac tamponade, not ICP.

Exact Extracts:

“Cushing’s triad includes bradycardia, hypertension, and irregular respirations.”

“Widening pulse pressure is a sign of increased intracranial pressure.”

“These are late signs indicating possible brain herniation.”