IBSC Certified Critical Care Paramedic Practice Test 2026 – Complete Exam Prep

The timing concept being tested is when the IABP inflates in relation to the cardiac cycle. The balloon should inflate during diastole, starting immediately after the dicrotic notch (which marks aortic valve closure), to boost diastolic pressure and improve coronary perfusion, and it should deflate just before systole to reduce afterload. If inflation occurs well after the dicrotic notch, the diastolic augmentation is delayed—late inflation. This blunts the intended rise in diastolic pressure and can push the inflation into late diastole or even into early systole, diminishing benefit and potentially worsening hemodynamics. On the waveform, this shows up as the inflation marker beginning after the notch rather than right after it. The other patterns imply timing that is either too early (inflating before systole) or would produce the expected immediate diastolic augmentation, not late inflation.