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The agreement of fingertip and sternum capillary refill time in children
  1. Jodie Crook1,
  2. Rachel M Taylor2,3
  1. 1Paediatric Department, St Bernards Hospital, Gibraltar Health Authority, Gibraltar, Gibraltar
  2. 2Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, UK
  3. 3Department of Children's Nursing, London South Bank University, London, UK
  1. Correspondence to Mrs Jodie Crook, Paediatric Department, Gibraltar Health Authority, Rainbow ward, St Bernards Hospital, Europort Avenue, Gibraltar, Gibraltar; Jodie.crook{at}


Objectives To determine the agreement of fingertip and sternum capillary refill time (CRT) in children.

Design Prospective, method-comparison study.

Setting Single children's emergency department, UK

Participants 92 children aged 0–12 years, with clinical observations within normal ranges for their age, no relevant medical history and presenting to hospital with a minor illness or injury.

Main outcome measures Agreement between fingertip and sternum CRT measurements.

Results Fingertip CRT ranged from 0.05 to 2.78 s with a mean of 1.08±0.44 and sternum CRT ranged from 0.85 to 2.38 s with a mean of 1.5±0.33. There was a significant difference between fingertip and sternum CRT (t=−9.2, df=91, p=<0.001) and a weak association between the two measurements (r=0.18, p=0.9). A Bland Altman comparison showed the mean difference between fingertip and sternum CRT was −0.49±0.51 with an upper and lower limit of agreement ranging from −1.5 (95% CI −1.69 to −1.32) to 0.53 (95% CI 0.34 to 0.71).

Conclusions Measurements of CRT taken at the fingertip and sternum are not comparable. Fingertip CRT was faster than sternum CRT. Normal CRT is 2–3 s. The current study questions the usefulness of CRT in the assessment of circulation in children.

  • Circulatory
  • Data Collection
  • Paediatric Practice
  • Accident & Emergency

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