Capillary Refill

Definition

Capillary refill time (CRT) is the time for color to return to a nail bed or skin area after pressure is applied and released. It is a rapid, non-invasive indicator of peripheral perfusion.

Normal Values

• Adults and children: less than 3 seconds
• Neonates: less than 2 seconds

Technique

Apply firm pressure to the nail bed or fingertip for 5 seconds; release and count seconds until color returns. Warm extremity first for accurate results.

Clinical Significance

Prolonged CRT (> 3 seconds) indicates decreased perfusion, such as hypovolemia, shock, hypothermia, dehydration, peripheral vascular disease, or compartment syndrome. Combined with other signs (tachycardia, cool extremities, low urine output), it signals impaired circulation.

Nursing Considerations

Include CRT in vital signs, fluid status assessments, and neurovascular ('6 P's') checks after casting or orthopedic surgery. Compare extremities bilaterally.

NCLEX Relevance

Normal: less than 3 seconds. Used to detect hypoperfusion in shock and assess circulation in extremities with casts.