MEDT 20: HEMATOLOGY 2 LABORATORY
Capillary Fragility Test
Learning Outcomes
After the completion of this module, you will be able to:
1. Discuss the principle and clinical significance of capillary fragility test.
2. Properly perform a common method for capillary fragility and interpret
results.
3. Knowing the correlation between the degree of thrombocytopenia to
capillary integrity.
Introduction
Capillary Fragility testing (Tourniquet Test) is a diagnostic procedure that assesses the
resilience and integrity of small blood vessels, known as capillaries. This test is valuable in
evaluating the fragility of capillary walls and their susceptibility to rupture, providing insights
into the vascular health of an individual.
Measuring the time it takes for petechiae (tiny red or purple spots) to appear on the
skin under controlled conditions, the capillary fragility test offers valuable information about
the patient's potential bleeding tendencies and vascular fragility.
Materials
1. Stethoscope
2. Blood pressure cuff / sphygmomanometer
Principle
An inflated blood pressure cuff on the upper arm is used to apply pressure to the
capillaries for 5 minutes. The arm is then examined for petechiae.
*Petechiae- minute hemorrhages under the skin and appear as skin bruises
Figure 1. Petechiae in the arm
FNAA 2024
MEDT 20: HEMATOLOGY 2 LABORATORY
Procedure
1. Examine the forearm, hand, and fingers to make a certain no petechiae are present.
Apply a blood pressure cuff on the upper arm above the elbow, and take a blood
pressure reading.
2. Inflate the blood pressure cuff to a point halfway between the systolic and diastolic
pressures (however, never exceeds a pressure of 100 mm Hg). Maintain this
pressure for five minutes.
3. Remove the blood pressure cuff and wait 5 to 10 minutes before proceeding.
4. Examine the forearm, hands, and fingers for petechiae. Disregard any petechiae
within ½ inch of the blood pressure cuff because this may due to pinching of the skin
by the cuff
5. Interpretation:
A count of greater than five (5) petechiae is POSITIVE in adult males.
A count of greater than ten (10) petechiae is POSITIVE in adult females and
children
6. The test results may be graded roughly as follows:
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 back of the hand
4+ Confluent petechiae on the arm and back of the hand
FNAA 2024
MEDT 20: HEMATOLOGY 2 LABORATORY
Name/s
Date
Year/Section/Cluster
1. Post a picture of the result after the procedure for capillary fragility test and
answer the given table. (5 points)
Picture:
Name of patient:
Counted petechiae:
Result:
Interpretation:
2. What is/are the conditions where a positive tourniquet test can be seen? (3
points)
3. How has the test evolved, and are there emerging technologies or
methodologies associated with capillary fragility assessment? (2 points)
References:
Brown, Barbara A. Hematology: Principles and procedures 6th Edition.
Turgeon, M. (2012). Clinical hematology: Theory & procedures 5th Ed. Jones
& Bartlett Learning
Elaine M. Keohane, Larry J. Smith, Jeanine M. Walenga 2016 Rodak's
Hematology Clinical Principles and Applications 5th Edition
FNAA 2024
