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iMedicalApps: Capillary Refill Trainer

Sepsis remains the 9th leading cause of disease-related death and the primary cause of infection-related death in the ICU. Sepsis is a devastating disease that results in over 250,000 deaths and 1.3 million hospitalizations per year. In February 2016, the Third International Consensus on Sepsis published “Sepsis 3.0,” the first new sepsis guidelines since 2003. The new guidelines were welcomed by many since the long interval time since “Sepsis 2.0,” but have already created a firestorm of controversy especially in emergency medicine. Much of this controversy is due to the move away from the systemic inflammatory response syndrome (SIRS) criteria in favor of the sequential organ failure assessment score (SOFA) and qSOFA scores. I encourage everyone to read the three excellent articles published by the “Sepsis 3.0” consensus group in JAMA.

These scoring systems all rely upon a high index of clinical suspicion. Frequently forgotten in all of the labs and rads is the physical examination. Septic patients as well as those with significant dehydration/hypovolemia, and trauma patients will have prolonged capillary refill. Do you know how to recognize it? I remember on my pediatrics rotations as a medical student being reminded again and again to check capillary refill and if it was less than 2 seconds, it was normal. So what is borderline and what are abnormal capillary refill times? If you are unsure, then check out this new simulation-based app from Jump Simulation and OSF Healthcare called Capillary Refill Trainer. This app teaches the proper classification via “realistic” patient scenarios in a simulation game. The app designers are the same team behind apps such as Hospital Readmission Challenge, AR Anatomy, and C. diff Risk Challenge, which we previously reviewed.

Capillary Refill Trainer is a simulation game that effectively teaches the basics of proper classification of capillary refill. The game is designed primarily with a sepsis backdrop but could be applied to dehydration, trauma, etc. Unfortunately, the game lacks any additional information, references, and teaching materials beyond the basic patient scenarios.


  • Game-based simulation to teach proper capillary refill classification
  • Helpful tutorial to ensure users understand the animated cases
  • Available for Android and iOS


  • Graphics are animations rather than realistic looking patients
  • Tutorial must be fully completed to access game
  • No educational materials, references, or other information about the game/scenarios

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