Capillary fragility test Flashcards
measures the ability of the capillaries to withstand the increased stress
Capillary fragility
Tourniquet test
Capillary fragility
Rumpel-Leede test, Hess test
Capillary Fragility
Capillary fragility is used to indicate
Thrombocytopenia, and can used with dengue
A positive-pressure test, used to measure the capillaries ability to remain intact under increased intracapillary pressure, is controlled by a blood pressure cuff around the patient’s upper arm.
Capillary Fragility Tourniquet test Rumpel-Leede test, Hess test
To assess the fragility of capillary walls.
To identify a platelet deficiency (thrombocytopenia).
Capillary Fragility Tourniquet test Rumpel-Leede test, Hess test
Patient preparation
Explain to the patient that this test is used to identify abnormal bleeding tendencies.
Tell him who will perform the procedure and when.
Inform him that food or fluids need not be restricted.
Explain that he may feel discomfort from the pressure of the blood pressure cuff.
Materials
Stetoscope, blood pressure cuff or sphygmomanometer
Parts of blood pressure cuff
Cuff, aneroid momanometer gauge, inflation bulb, air release
Parts of stetoscope
Eartips, bell, diaphragm.
small red or purple spots of the skin surface that can be caused by minor hemorrhage due to the rupture off capillaries
Petechiae
Step 1 of the procedure
Examine the forearm, hand and fingers to make certain that no petechiae are present.
step 2
Apply a blood pressure cuff on the upper arm above the elbow, and take blood pressure reading.
Step 3
Inflate the blood pressure cuff to a point midway between the systolic and diastolic blood pressures for five minutes. (systolic+diastolic=____ / 2 =
Step 4
After deflating the cuff, wait for the skin to return to its normal color (usually about five to ten minutes).
step 5
Count the number of petechiae visible in a one-inch square area on the ventral surface of the forearm. Disregard any petechiae within 1.2 inch if the blood pressure cuff because this may be due to pinching of the skin by the cuff.
What will you do if there is a petechiae present in step 1?
Take note of the petechiae and do not count that petechiae after deflating the pressure from the cuff
reported as positive
> 10 petechiae
1+
a few petechiae on the anterior part of the forearm
2+
many petechiae on the anterior part of the forearm
3+
multiple petechiae over the whole arm and the back of the hand
4+
confluent petechiae on the anterior part and back of the hand
Precautions
Do not repeat this test on the same arm within 1 week.
This test is contraindicated in patients with disseminated intra vascular coagulation (DIC) or other bleeding disorders, and in those with significant petechiae already present.
A positive finding (more than 10 petechiae or a Score of 2+ to 4+) indicates ________.
weakness of the capillary walls (vascular purpura) or a platelet defect.
Give atleast 8-12 conditions that may occur in abnormal findings.
thromboccytopenia, thrombasthenia, purpua senilis, scurvy, DIC, von Willebrand’s disease, vitamin K deficiency, dysproteinemia, and polycythemia vera and in severe deficiencies of factor VII, fibrinogen, or prothrombin.
Conditions unrelated to bleeding defects, such as scarlet fever, measles, influenza, chronic renal disease, hypertension, and diabetes with coexistent vascular disease, may also increase capillary fragility. True or False?
True
abnormal finding
An abnormal number of petechiae sometimes appear before menstruation and at other times in some healthy persons, especially in women over age 40.
Interfering factors
Decreasing estrogen levels in postmenopausal women (possible increase)
Glucocorticoids (possible decrease)
Repeating the test on the same arm within 1 week, causing errors in counting the number of petechiae.
Overinflation or underinflation of the cuff.
