Licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon, British Columbia Institute of Technology. © 2015 British Columbia Institute of Technology (BCIT). Rectal, Forehead or Ear temperature: 100.4 F (38.0 C) or higher Oral (mouth) temperature: 100 F (37.8 C) or higher Under the arm (armpit) temperature: 99 F (37.2 C) or higher Caution: Ear temperatures are not accurate before 6 months of age Where to Take the Temperature Rectal temps are the most accurate. Part of this content was adapted from OER #1 (as noted in brackets above): It is important to check your agency policy regarding tympanic temperature. The tympanic temperature is not measured when a client has a suspected ear infection. 1 However, temperature is now routinely measured at other more convenient sites including the ear, mouth, forehead, and axilla, often with a conversion or fudge factor added to estimate the rectal temperature. It concluded that tympanic temperature is one option for use with children, but suggested using rectal temperature for children younger than two, particularly when accuracy is vital. Rectal temperature is considered the gold standard by many and outcome studies have often used rectal temperature to make clinical decisions. The Canadian Pediatric Society found equal evidence for and against the use of tympanic temperature route (Leduc & Woods, 2017). Although research has proven the accuracy of this method, some pediatric institutions prefer the accuracy of the rectal temperature. The tympanic temperature method is a quick and minimally invasive way to take temperature. What should the healthcare provider consider? The ear canal is a sensitive and a highly innervated part of the body, so it is important not to force the tympanic probe into the ear. The probe tip is gently inserted into the opening to prevent damage to the ear canal. If this is not correctly done, the reading may not be accurate. Licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.The technique of pulling the helix up and back (adult) or the lobe down (child under 3) is used to straighten the ear canal so the light can reflect on the tympanic membrane. Follow these steps: 3 Put petroleum jelly or a water-soluble lubricant (such as KY-Jelly or Surgilube) on the end of the thermometer. Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon, British Columbia Institute of Technology. Steps to Take a Rectal Temperature To take a rectal temperature, you'll need a digital thermometer and a lubricant. © 2015 British Columbia Institute of Technology (BCIT). Healthcare providers should wait about 5 minutes if the client is chewing gum or has just smoked since both of these activities can increase temperature. The temperature of the beverage/food also factors into the wait period, as extreme heat or cold will require longer wait times for oral temperature assessment. If another route is not available, healthcare providers should wait 15 to 25 minutes to take the oral temperature following consumption of a hot or cold beverage/food. Urinary bladder temperature (Tb), measurement of temperature with a specially designed temperature probe embedded in a Foley urinary catheter, could be a favor-able alternative to Tr in the ICU because rectal probe insertion is not required without the need for additional procedures 5,6. Selecting an alternate route under the aforementioned circumstances is most conducive to a fast-paced clinical environment and most respectful of the client’s time. If the client has recently consumed hot or cold food or beverage, chewing gum, or has smoked prior to measurement, the healthcare provider should use another route such as tympanic or axillary. Measurement of the oral temperature is not recommended for individuals who are unconscious, unresponsive, confused, have an endotracheal tube secured in the mouth, and cannot follow instructions.Ĭertain factors render the oral route less accurate with the potential for falsely high or falsely low findings. Rectal temperature measurement is considered to be the gold standard for children 3 years of age or younger. Healthcare providers often measure the oral temperature, particularly when the client is conscious and can follow directions. If so, discard the probe cover and re-insert the probe into the device to reset it. Sometimes the device will turn off after you take the probe out of the device if you take too long to put the probe cover on or insert it in the client’s mouth. You need to ensure that it snaps onto the probe. Putting the probe cover on takes practice.
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