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Capillary nail refill test
Nail blanch test; Capillary refill time
The capillary nail refill test is a quick test done on the nail beds. It is used to monitor dehydration and the amount of blood flow to tissue.
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how muc...
How the Test is Performed
Pressure is applied to the nail bed until it turns white. This indicates that the blood has been forced from the tissue. It is called blanching. Once the tissue has blanched, pressure is removed.
While the patient holds their hand above their heart, the health care provider measures the time it takes for blood to return to the tissue. Return of blood is indicated by the nail turning back to a pink color.
How to Prepare for the Test
Remove colored nail polish before this test.
How the Test will Feel
There will be minor pressure to the bed of your nail. This should not cause discomfort.
Why the Test is Performed
Tissues need oxygen to survive. Oxygen is carried to various parts of the body by the blood (vascular) system.
This test measures how well the vascular system works in your hands and feet -- the parts of your body that are farthest from the heart.
Normal Results
If there is good blood flow to the nail bed, a pink color should return in less than 2 seconds after pressure is removed.
What Abnormal Results Mean
Blanch times that are greater than 2 seconds may indicate:
- Dehydration
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Shock
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs...
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Peripheral vascular disease
(PVD)
Peripheral vascular disease
Peripheral artery disease (PAD) is a condition of the blood vessels that supply the legs and feet. It leads to narrowing and hardening of the arteri...
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Hypothermia
Hypothermia
Hypothermia is dangerously low body temperature, below 95°F (35°C).
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References
White CJ. Atherosclerotic peripheral arterial disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.
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Nail blanch test - illustration
The nail blanch test, also called the capillary nail refill test, is performed on the nail beds as an indicator of tissue perfusion (the amount of blood flow to tissue) and dehydration.
Nail blanch test
illustration
Review Date: 4/30/2015
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
