Medicine Best and earliest bedside clinical sign of respiratory pump failure: A Use of intercostal muscles (accessory muscles of respiration) B Paradoxical respiratory motions (Abdominal respiration or paradox) C Tachypnea D Cyanosis. 💡 Explanation Best and earliest bedside clinical sign of respiratory pump failure: ✓ Correct Answer: B. Paradoxical respiratory motions (Abdominal respiration or paradox)