The capillary refill test is a rapid, non-invasive assessment used to evaluate peripheral circulation, the blood flow to the body’s extremities. This test checks how efficiently blood reaches the tiny vessels, called capillaries, just beneath the skin’s surface. It indicates tissue perfusion, the delivery of oxygen and nutrients to tissues. The test helps identify potential issues with blood circulation.
Performing the Capillary Refill Test
Ensure patient comfort and proper limb positioning. The hand or foot should be at heart level, or slightly elevated, to prevent venous pooling. The extremity must be warm, as cold temperatures constrict blood vessels and influence refill time. If cold, gently warm it before testing.
Common locations are the fingernail or toenail beds. For infants or when peripheral sites are unreliable, the test can be performed on the sternum (breastbone) or forehead. Apply firm but gentle pressure to the chosen site until the area turns white, indicating temporary blood displacement. Maintain this pressure for about five seconds.
Upon releasing pressure, immediately observe and time how long it takes for the pink color to return to the blanched area. This signifies capillary refilling. Measure the refill time accurately, using a watch or clock. Repeat the test on another digit or area if needed, comparing results for consistency.
Interpreting and Documenting Capillary Refill Results
Interpreting refill time provides insight into circulatory status. A normal capillary refill time for adults and children is less than two seconds, indicating healthy blood circulation. Some sources suggest up to three seconds may be normal in adults, though less than two seconds is widely accepted as optimal. When color returns within this timeframe, it suggests adequate blood flow.
A prolonged refill time, typically greater than two seconds, may suggest poor peripheral perfusion, dehydration, or early shock. It signals blood is not returning to the capillaries quickly enough, indicating reduced blood volume or compromised circulation. However, several factors influence capillary refill time, including ambient temperature, patient body temperature, age, poor lighting, and nail polish. Consider these factors when interpreting results to avoid misinterpretation.
Accurate documentation of capillary refill results is important for monitoring changes over time and communicating findings. Documentation should include the specific refill time in seconds and the exact test location (e.g., right index finger, sternum). Note the skin’s appearance before and after the test, any influencing factors (like cold extremities or nail polish), and the patient’s overall condition. Record the date and time of assessment for a comprehensive record.