Cushing's triad consists of three vital sign measures reflecting ICP. Which combination is correct?

• A. Increased pulse, irregular respiration, increased BP
• B. Decreased pulse, irregular respiration, increased pulse pressure
• C. Decreased pulse, irregular respiration, increased pulse pressure
• D. Decreased pulse, increased respiration, decreased systolic BP

Answer: (C)

Rising intracranial pressure triggers the Cushing reflex, a late sign of ICP elevation, which shows a characteristic triad: bradycardia, irregular respirations, and a widened pulse pressure. In practice, this means a decreased pulse (bradycardia), irregular breathing pattern, and an increased difference between systolic and diastolic BP (wide pulse pressure). The increased systolic BP helps push blood through the compressed brain, while the heart rate slows via baroreceptor reflexes, and brainstem compression leads to irregular respirations. So the combination described as decreased pulse, irregular respiration, and increased pulse pressure best fits Cushing’s triad.