Micro-lectures

Paramedics Course -Capillary Refill Time

Capillary Refill Time

Micro-lecture by the Australian Paramedical College

 

In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis talks about capillary refill time.

 

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Capillary Refill Time


Today, we are going to talk about capillary refill time. Now, capillary refill time is something you will have already read out in the materials. Now certainly, some of you will have already be using capillary refill time as a method for assessing our patient’s circulation and there will be others who have neither read about it, never heard about it, and never experienced using it. Now, capillary refill time is something that is extremely important to you guys’ paramedics. Please get into the habit as soon as possible and using it as part of your routine assessment. Now as you will already know, as a paramedic, you need to collect individual pieces of information about your patient’s history, their past, their clinical signs and symptoms and piece them all together to form the actual picture that’s occurring right in front of you.

Capillary refill time is something that you guys will find extremely useful in helping you to determine if the patient is sick or not sick. As you can see on here, you can see somebody pressing down on somebody else’s finger. Basically, what they’re doing is they’re compressing the finger and they’re pressing the capillary bed stopping the circulation in the capillary bed. Now the idea is in a healthy circulation, the moment you lift the finger up, the blood should return back to the finger or wherever you’re pressing down, therefore being a good sign. The way that we do it is that we choose our location and we can either use the typical nail bed, we can use the finger bed or the thumb, anywhere where there’s circulation here in the peripheries.

We can choose the forehead. We can choose the chest, which is the central capillary refill time, so basically you can choose a wide range of different places. Now, what you do is it’s that simple. You press down and you press for five seconds. On my finger now, just notice how you’ve got a nice pink colour there. You press down for five seconds and it goes white. One, two, three, four, five. It goes back pink within two seconds. It’s a really fast process. That’s a good sign and I’m glad it went pink so quickly because otherwise I would’ve been in trouble. Again, that’s another part. You always treat the patient and not the single diagnostic tool. In other words, if my fifth finger hadn’t taken well in three to five seconds, I wouldn’t have worried because I feel fine.

I don’t have any symptoms. In isolation, it’s not that useful. Press down for five seconds, lift it up, and it should go back to a normal colour within two seconds. Anything longer than two seconds is called a prolonged capillary refill time. When you piece it together with, say, a tachycardia, signs of shock, and it’s not a good sign and it helps you as the paramedic to conclude that your patient is not that well. Okay. That’s the micro-lecture on capillary refill time. Hope you’ve enjoyed the short lecture and I look forward to speaking to you guys again shortly. Take care.

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