Capillary Refill Time (CRT) Guide  

Definition: Capillary refill time is the time taken for colour to return to an external capillary bed after it has been compressed. It reflects peripheral perfusion and helps assess circulatory status (Note Central Capillary refill is measured on the sternum, mid axillary line) 

Normal CRT: <2 seconds (adults and children). 

Step-by-Step Procedure: 

Explain the procedure to the patient 
Inform the patient what you are doing. 

Position the patient appropriately 
Hand at heart level (if measuring on hands – most common peripheral site). 
Central – sternum 

Select a site 
Nail bed of finger or toe. 
Central – sternum 

Apply pressure 
Press firmly on the nail bed or skin for 5 seconds until blanching occurs. 
Central – Press firmly on the sternal bone with your thumb about mid axilla line for 5 seconds 

Release and observe 
Count in seconds how long it takes for colour to return. 

Measure the time 
Normal: <2 seconds 
Delayed: >2 seconds, may indicate poor perfusion. 

Document findings 
Example: “CRT <2 seconds, normal” or “CRT 4 seconds, delayed.” 

Tips for Accuracy: – Ensure ambient temperature is not cold. – Avoid jaundiced skin for assessment. – Compare both hands if needed. – Interpret in context with vital signs and other clinical findings. 

Clinical Relevance:  
– Delayed CRT may indicate: – Shock (hypovolemic, septic, cardiogenic),- Dehydration, – Hypothermia, – Peripheral vascular disease 

Note: Normal CRT does not rule out poor perfusion.