Capillary refill time in sick children

Capillary refill time (CRT) is widely recommended as part of the routine assessment of sick children. Recent systematic reviews have resulted in better understanding of the validity and diagnostic value of this test. We recommend standardisation of the measurement of capillary refill time. Moderate pressure should be applied to a finger for five seconds, at an ambient temperature of 20-25°C. Capillary refill times of three seconds or more should be considered abnormal.A prolonged capillary refill time is a specific sign for a range of serious conditions in children, and is appropriate for use as a “red-flag” in primary care. However, a normal capillary refill time (2 seconds or less) has low sensitivity, and so should not be interpreted as a reassuring sign.