Capillary refill time in a child with shock is

Capillary refill is a simple test that assesses how quickly blood returns to the skin after pressure is applied. It is carried out by applying pressure to the pink pa of the nail bed of the thumb or big toe in a child and over the sternum or forehead in a young infant for 3 seconds. The capillary refill time is the time from release of pressure to complete return of the pink color. It should be less than 3 seconds. If it is more than 3 seconds the child may be in shock. Lift the limb slightly above hea level to assess aeriolar capillary refill and not venous stasis. This sign is reliable except when the room temperature is low, as the cold environment can cause a delayed capillary refill. In such a situation check the pulses and decide about shock