FAQ Level 3 Award for First Responders on Scene: Emergency First Responder (RQF) FROS® - Online Blended Part 1

218 videos, 11 hours and 47 minutes

Course Content

Capillary Refill

Video 102 of 218
3 min 26 sec
English
English
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Let us take a look at capillary refill. What does it tell us, where do we find it and what information can we glean from it? So, a capillary refill is basically when we squash blood from the capillaries in the body and allow them to refill via the pumping and pressures of the heart and blood. The main four areas for capillary refill are the tips of the fingers, the tips of the toes, the forehead, and the centre of the chest. The tips of the finger and the tip of the toe is mainly used in adults. The tip of the forehead and the tip of the chest is mainly used in children but can be used on adults as well. When we squeeze the blood from the distal capillaries, the heart and the pressures inside of the body will refill the capillary blood vessels and that capillary bed and it should take no more than two seconds to refill.

It is a very, very good, quick and easy and simple way to check a patient's blood pressure developing shock. But there are a few things that we need to take into consideration. Cold hands and feet, for one, if the hands are cold and the feet are cold, blood draws back to the core and consequently, makes the actual technique a little bit unreliable, but we have to take that into consideration. So temperature is important. Light is another. It is very, very difficult to see the cap refill effectively in dark light conditions. So again, it is a system that needs to be used in decent light or with floodlit areas where you can actually see what you are doing and see the proper colour and re-capillary filling of that area. So taking a capillary refill. It is taken from the furthest point from the heart, the tip of the finger, or the tip of the toe. We then apply pressure over the nail, squeezing firmly to squeeze blood from the capillary bed. We then release and the colour rushes back in to fill the capillary bed, changing the colour from white back to pink.

This should take no longer than two seconds. We have talked about capillary refilling profusion on the fingertips, but it is also used in other areas as well, one of those being the toes. It does not only check blood pressure and circulation, but it also tells us where there is good blood flow, past an injury, past a bandage or past a torniquet or anything that is occluding blood vessels. It may be a fracture, a dislocation, a break, a stabbing, or even we have put a bandage on too tight and we are not allowing blood to flow past the bandage, which means that we are going to have a problem with the limb if we do not sort it out. So it's a very, very good indicator of flow and pressures and blockages with limbs, fractures, breaks. Capillary refill is also used very effectively on children. However, we do not tend to use the fingers and toes on children because they are so small and difficult to see the capillary refill taking place.

We tend to use the forehead or the chest. Children are always nice and pink and well profused. So if we press on the forehead gently or on the chest gently, we get exactly the same effect that we would get on an adult on the finger or the toe. The area goes white. You take your finger away and the area refills with blood, it becomes re-profused and goes nice and pink. On a cap refill on a child on the forehead and on the chest, this refilling time should be less than one second. On an adult, fingertips and toes, it should be below two seconds.

Learning Outcomes:
  • IPOSi Unit three LO3.1, 3.2, 3.3 & 3.4