Capillary nail refill test

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.

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.

Also known as: Nail blanch test and Capillary refill time

Definition

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.

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 Values

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:

References

White CJ. Atherosclerotic peripheral arterial diseases. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2011:chap 79.

See also

  • Injury

    Hypothermia

    Dressing appropriately is important when exercising in cold weather. Here are some tips to consider:Wear several layers, including gloves and a hat. Remove layers when you warm up, and replace them during the slower portions of your workout.If it is snowing or icy, be extra careful to not fall.Remember, you can still become dehydrated in cold weather, you still need plenty of fluid before, during, and after exercise.

    Hypothermia is dangerously low body temperature, below 95 °F (35 °C).

  • Injury

    Shock

    Shock is a severe condition that occurs when not enough blood flows through the body, causing very low blood pressure, a lack of urine, and cell and tissue damage.

    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 do not...

  • Disease

    Dehydration

    A decrease in skin turgor is indicated when the skin (on the back of the hand for an adult or on the abdomen for a child) is pulled up for a few seconds and does not return to its original state. A decrease in skin turgor is a late sign of 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 much of...

  • Disease

    Peripheral artery disease - legs

    Atherosclerosis of the extremities is a disease of the peripheral blood vessels that is characterized by narrowing and hardening of the arteries that supply the legs and feet. The narrowing of the arteries causes a decrease in blood flow. Symptoms include leg pain, numbness, cold legs or feet and muscle pain in the thighs, calves or feet.

    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 arteries. This...

Review date:
November 13, 2014
Reviewed by:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
Copyright Information A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.