Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 As I've understood it, capillary refill is an accurate means of determining perfusion, but the time for capillary refill varies with age and gender as well as certain environmental conditions. -Wes Ogilvie Capillary Refill One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 I think your student has it backwards...I would much rather use it for an adult than a child. Additionally, concern should be noted towards ambient temperatures...if its cold, it will be delayed. In normal conditions with one patient, I would suggest capnography if you want to really have an idea of perfusion. It is far more accurate than squeezing a finger. As for MCIs, I'd stick with pulse checks rather than cap refill. C Capillary Refill One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 I still use cap. refill often as well. I guess it is an old habit but have not heard of any change in checking cap. refill hypnoron@... wrote: One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 Hello, Reference: AAOS 9th ed. Page 156 " However, it is a much more reliable indicator of cardiovascular status in children than it is in adults... Steve ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of hypnoron@... Sent: Wednesday, April 12, 2006 4:16 PM To: texasems-l Subject: Capillary Refill One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 Yet another interesting article on Capillary Refill. Back in the day, we looked for normal or delayed. I appeared to be an effective method back then for the pre-hospital setting. bkw Capillary refill time in term neonates: bedside assessment. Raichur DV, Aralihond AP, Kasturi AV, Patil DH. Department of Pediatrics, Karnatak Institute of Medical Sciences, Hubli-580022, India. dr.devaraj@... Capillary refill time (CRT) is yet to be established as a specific clinical sign of peripheral circulation in neonates. This study was conducted to assess the influence of four body sites used for measurement, interobserver variability, sex, birth weight, age at assessment and room temperature on CRT recorded in healthy term neonates, at bedside. Two observers measured CRT in four different body sites (forehead, chest, palm and heel) of each of 155 healthy term neonates. Significant differences occurred between the mean CRT recorded by the two observers in forehead (mean +/- SD: 2.62 +/- 0.8 s and 1.88 +/- 0.57 s; p < 0.001), palm (2.99 +/- 0.61 s and 2.75 +/- 1.12 s; p < 0.05) and heel (3.08 +/- 0.79 s and 4.24 +/- 1.84 s; p < 0.001). Only CRT in chest (2.7 +/- 0.42 s and 2.62 +/- 0.74 s) produced no significant differences in the means with a statistically significant and clinically fair, but not strong, interobserver agreement (r = 0.4; p < 0.001). No significant associations occurred between CRT and sex or birth weight. The associations of chest CRT with age at assessment (r = -0.23; p < 0.01) and room temperature (r = 0.27; p < 0.01) were clinically not important. In conclusion, CRT in neonates needs to be validated further before it can be useful as a specific clinical sign of peripheral circulation. PMID: 11519284 [PubMed - indexed for MEDLINE] Capillary Refill One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 Yet another interesting article on Capillary Refill. Back in the day, we looked for normal or delayed. I appeared to be an effective method back then for the pre-hospital setting. bkw Capillary refill time in term neonates: bedside assessment. Raichur DV, Aralihond AP, Kasturi AV, Patil DH. Department of Pediatrics, Karnatak Institute of Medical Sciences, Hubli-580022, India. dr.devaraj@... Capillary refill time (CRT) is yet to be established as a specific clinical sign of peripheral circulation in neonates. This study was conducted to assess the influence of four body sites used for measurement, interobserver variability, sex, birth weight, age at assessment and room temperature on CRT recorded in healthy term neonates, at bedside. Two observers measured CRT in four different body sites (forehead, chest, palm and heel) of each of 155 healthy term neonates. Significant differences occurred between the mean CRT recorded by the two observers in forehead (mean +/- SD: 2.62 +/- 0.8 s and 1.88 +/- 0.57 s; p < 0.001), palm (2.99 +/- 0.61 s and 2.75 +/- 1.12 s; p < 0.05) and heel (3.08 +/- 0.79 s and 4.24 +/- 1.84 s; p < 0.001). Only CRT in chest (2.7 +/- 0.42 s and 2.62 +/- 0.74 s) produced no significant differences in the means with a statistically significant and clinically fair, but not strong, interobserver agreement (r = 0.4; p < 0.001). No significant associations occurred between CRT and sex or birth weight. The associations of chest CRT with age at assessment (r = -0.23; p < 0.01) and room temperature (r = 0.27; p < 0.01) were clinically not important. In conclusion, CRT in neonates needs to be validated further before it can be useful as a specific clinical sign of peripheral circulation. PMID: 11519284 [PubMed - indexed for MEDLINE] Capillary Refill One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 I must admit I'm not familiar with AAOS textbooks but BTLS, 5/e says persistent tachycardia is " the most reliable indicator of shock in a child " ...it also notes cap refill is okay, but that there are multiple reasons for false positives and positive falses that cap refill alone is inadequate. I still think as caqpnography spreads this discussion will be moot. There are a couple of studies with cardiac arrest patients where cardiac output is measured by capnography minutes prior to a health care provider feeling a pulse. Capillary Refill One of our new EMT's was sharing that capillary refill is a great tool if the patient is 6 years old or under, but not as accurate in adults. I have always use capillary refill as a tool. So, my question is, is capillary refill still an acceptable practice to determine perfusion, in normal conditions? What about capillary refill on a MCI? It's been a while since I have been in EMT school, I find it interesting on what the " newer " people are learning. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 Capillary refill is a very useful tool for checking circulation status in infants and children under the age of six, unless they are suffering from hypothermia. Capillary refill is not generally a good indicator for adults.[AAOS 9e; Brady 10e] As for MCI's, The START triage works extremely well using only Respiration; Pulse; Mental Status to prioritize your patients condition. Myron Schmiedekamp, EMS Coordinator. On Wed, 12 Apr 2006 17:16:00 EDT hypnoron@... wrote: > One of our new EMT's was sharing that capillary refill >is a great tool if > the patient is 6 years old or under, but not as accurate >in adults. I have > always use capillary refill as a tool. > > So, my question is, is capillary refill still an >acceptable practice to > determine perfusion, in normal conditions? > > > What about capillary refill on a MCI? > > It's been a while since I have been in EMT school, I >find it interesting on > what the " newer " people are learning. > > Ron > > > Quote Link to comment Share on other sites More sharing options...
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