How is capillary refill time assessed and what does a refill time greater than two seconds indicate?

• A. Press nail bed until blanching, release and count seconds; refill >2 seconds indicates poor perfusion or shock.
• B. Palpate the wrist pulse and measure time for color return.
• C. Ask the athlete to clench fist; no refill test.
• D. Apply cold therapy and observe skin color change.

Answer: (A)

The main idea is to quickly assess how well blood is reaching the skin by measuring capillary refill time. To do this, apply firm, steady pressure to a nail bed (or fingertip) until the skin blanches. Then release and watch how long it takes for color to return, counting the seconds. A refill time of less than two seconds is normal and suggests adequate peripheral perfusion. If the color takes longer than two seconds to return, that indicates reduced peripheral perfusion, which can occur with dehydration, cold exposure, vasoconstriction, or shock. In practice, consider factors like temperature, lighting, and the exact site, and always look for other signs of poor perfusion if CRT is prolonged.