Which of the following is a characteristic sign of volume depletion?

• A. Prolonged jugular refill
• B. Normal jugular fill
• C. Normal pulses
• D. BAR mentation

Answer: (A)

Volume depletion lowers the effective circulating blood volume, so the venous system to the heart is under-filled. A classic exam sign is the jugular veins taking longer to refill after you occlude and release them—jugal refill is prolonged. This slow refill reflects the reduced venous return and low central venous pressure that accompany dehydration. In contrast, normal jugular fill would suggest adequate circulating volume, normal or strong pulses would indicate better perfusion, and mentation labeled BAR is not a reliable hallmark of volume depletion. So the delayed jugular refill best signals reduced blood volume.