In a 5-year-old with dehydration and signs of poor perfusion, which finding indicates poor perfusion?

In a 5-year-old with dehydration and signs of poor perfusion, which finding indicates poor perfusion?

• A. Capillary refill time of 4 seconds
• B. Normal skin color
• C. Alert and interactive
• D. Delayed capillary refill is not a sign of poor perfusion

Answer: (A)

Capillary refill time is a quick bedside indicator of peripheral perfusion. In children, refill should be about 2 seconds or less. A capillary refill of 4 seconds shows the blood is not returning to the skin promptly, reflecting poor peripheral perfusion and possible shock from dehydration. This makes it the best sign in this scenario. Normal skin color and being alert can occur even when perfusion is compromised, so they don’t reliably indicate good perfusion. And saying that delayed capillary refill isn’t a sign is incorrect because delayed refill directly signals reduced blood flow to the periphery.

Capillary refill time is a quick bedside indicator of peripheral perfusion. In children, refill should be about 2 seconds or less. A capillary refill of 4 seconds shows the blood is not returning to the skin promptly, reflecting poor peripheral perfusion and possible shock from dehydration. This makes it the best sign in this scenario. Normal skin color and being alert can occur even when perfusion is compromised, so they don’t reliably indicate good perfusion. And saying that delayed capillary refill isn’t a sign is incorrect because delayed refill directly signals reduced blood flow to the periphery.