Capillary refill as an indication of SpO2

[Joeleone52]

One of my coworkers was explaining to me his old basic school taught him that you can use capillary refill time for an indication of the patients SpO2%. Has any one else been taught that? (I’m talking about actual ranges of percentages NOT overall perfusion)

 

[DesertMedic66]

No

 

[Peak]

No. My CHD kids can have a brisk cap refill with a sat in the 60s. Patients who are clamped down may have very delayed cap refill and have a good sat.

 

[Carlos Danger]

That's exactly backwards. Cap refill is a rough indicator of perfusion, of which Sp02 is one of the many factors. But it doesn't correlate at all to any range of hemoglobin saturation.

 

[Summit]

OP it's good that you question and good that you ask, because your coworker is totally wrong.

 

[DrParasite]

ummmmm your coworker is wrong.

But I am glad you actually asked someone vs believing his incorrect information as factually correct.

 

[E tank]

probably confusing capillary bed color with O2 sat or something.

 

[johnrsemt]

I have never had poor cap refill; I have had SPO2 in to the mid 60's (64% was the lowest I remember, and I was there for a few hours) but I am weird that way.

 

[Bullets]

As others have said, its a rough indicator of how well a patient is perfusing, but in no way correlates to the actual oxygen saturation

 

[johnrsemt]

I have been as low as 65%, totally coherent, great cap refill.
Also had BP as low as 62/20 with strong radial pulses.

 

[E tank]

I have been as low as 65%, totally coherent, great cap refill.
Also had BP as low as 62/20 with strong radial pulses.

So are you the rule or the exception? And in the ordinary circumstances where we would encounter an adult with a sat of 65 and MAP of 34, what would we see? What is it that you are arguing?

 

[RaleighM]

I believe it is a more accurate method for children, but not necessarily for adults.

 

[Peak]

I believe it is a more accurate method for children, but not necessarily for adults.

Negative.

In the otherwise healthy child the most common cause for delayed capillary refill is dehydration.

 

[johnrsemt]

I was saying that low O2 % doesn't mean that you have corresponding slow cap refill;

I need to stop posting when I am tired;

Also trying to comment that the theory of radial pulses = BP of at least 90 systolic doesn't always work

 

[RaleighM]

Definition of capillary refill according to the eleventh edition of the Orange Book (AAOS Emergency care and transport of the sick and injured): A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of it return after releasing the pressure.

It goes on to say "When evaluated in an uninjured limb, capillary refill time (CTR) may provide an indication of the pediatric patient's level of perfusion. It should be kept in mind, however, that especially in an adult patient, capillary refill can be affected by the patient's position, age, history as a smoker, history of medical problems such as diabetes, medications the patient is currently taking, and exposure to a cold environment (hypothermia) including frozen tissue (frostbite) and vasoconstriction (narrowing of a blood vessel)."

 

[medic2EMSdoc]

Cap refill give some indirect measure of perfusion where as, Spo2 is a indirect measurement of the bound amount of oxygen to rbc's.