Capillary refill time is only useful if it is measured consistently. Press firmly on the pad of the index finger, with the hand at heart level, enough to blanch it, and hold for about ten seconds. Release and time the return of colour with a watch rather than by counting aloud.
In adults, more than three seconds is generally taken as abnormal. Cold surroundings, poor light and darker skin make it harder to read; warm the hand and use good light. Repeat it after each intervention so it becomes a trend rather than a single number.
- Press firmly on the fingertip pad for about ten seconds with the hand at heart level.
- Time the refill with a watch, not by counting.
- Treat more than three seconds in adults as abnormal.
- Repeat after every fluid or vasopressor change.
Why it matters
An inconsistent technique turns a useful sign into noise.
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