Left half is the patient’s baseline tone; right half shows the “now” appearance. Toggle color changes and run cap refill to visualize perfusion.
Color changes
- Flushed: vasodilation (fever, early sepsis, exertion, anaphylaxis, CO₂ retention).
- Cyanotic: deoxygenated Hb. Central (tongue/lips) → hypoxemia; peripheral (nails) → cold/low cardiac output.
- Jaundice: elevated bilirubin (liver disease, obstruction, hemolysis). Check sclerae/mucosa; subtle on darker skin.
- Pale: anemia, shock/low perfusion, vasoconstriction, cold exposure.
Capillary refill
Blanches then returns to baseline. <2 s often normal (warm). >2 s (4 s demo) suggests poor perfusion, hypothermia, or vasoconstriction—interpret with overall context.
Moisture & Temperature
- Dry→Wet: from dehydration/fever chills (dry) to diaphoresis (wet) in shock, fever, pain, anxiety.
- Temp: low skin temp (cool) can reflect vasoconstriction/exposure; fever may cause warmth/flushing.