II. Technique: Rectal Temperature
- Procedure
- Apply vaseline or KY Jelly to rectal Thermometer
- Patient lies on their side with top leg flexed forward
- Children and uncooperative patients should be held by an assistant to prevent movement
- One hand spreads the buttocks and exposes the anal region
- Thermometer tip gently inserted through anus into Rectum 0.5 to 1 inch depth
- Stop insertion if any resistance is met
- May use the reading if the depth is at least 0.5 inches
- Thermometers typically indicate with sound when the reading has stabilized and Temperature may be read
- Advantages
- Most accurate, non-invasive method for detecting fever
- Disadvantages
- Lag core Temperature changes
- Variable readings depending on depth or insertion and presence of stool in Rectum
- Risk of contagious illness spread
- Discomfort for both the patient and the parent performing the Temperature
- Case reports of rectal perforation in infants
III. Technique: Oral Temperature
- Procedure
- Patient sits in comfortable, stable position
- Thermometer placed under Tongue and with lips closed around it
- Patient instructed not to bite down on Thermometer
- Thermometers typically indicate with sound or other signal when the reading has stabilized and Temperature may be read
- Advantages
- Comfortable, easily accessible site for Temperature measurement (reflects the lingual artery Temperature)
- More accurate than acillary Temperatures (but less accurate than Rectal Temperatures)
- Disadvantages
- Altered by eating or drinking with the prior 15 minutes
- Adequate reading requires a closed mouth and Thermometer held under the Tongue for 3-4 minutes
- Not appropriate for uncooperative or unconscious patients
- Not appropriate for young children especially under age 2 years
- Not able to maintain sublingual positioning, may bite Thermometer
- Pacifier Thermometers are an alternative option in this age, but must stay in mouth for 6 minutes
IV. Technique: Tympanic Temperature
- Procedure
- Insert Thermometer tip into ear canal
- Press start
- Wait for sound or other signal to indicate Temperature may be read
- Advantages
- Fast, convenient, comfortable and easy to perform
- Disadvantages
- Poor accuracy (similar to Axillary Temperature)
- Affected by environmental Temperature, Cerumen Impaction and Otitis Media
- Not appropriate for under age 6 months
V. Technique: Forehead or Temoral Temperature (No-Touch Infrared Thermometer)
- Procedure
- Infrared device placed over central forehead distribution region (NOT In contact: 2 inches away from skin)
- Use the Thermometer outside of Temperature extremes, in a non-drafty environment, out of direct sunlight
- Wipe away sweat or dirt from the testing skin surface
- Patient should move their hair and clothing away from the forehead area intended to test
- Wait a few minutes after patient arives from hot or cold environments, and allow time to cool off from Exercise
- Recheck questionable results
- Store the Thermometer outside of Temperature extremes
- May clean with Alcohol and soft cloth, but avoid touching the sensor
- Advantages
- Fast and simple
- Accurate and reliable when used correctly
- Use with no contact of the device with the patient
- Disadvantages
- Most expensive of Thermometers
- Error prone
- Pitfalls resulting in a false reading
- Moisture on the forehead
- Ambient Temperature effects on skin Temperature
- Infrared gun is not held steady at single point
- References
- (2020) Presc Lett 27(11): 63
VI. Technique: Axillary Temperature
- Procedure
- Place Thermometer snugly against skin in axilla with arm adducted
- Thermometers typically indicate with sound or other signal when the reading has stabilized and Temperature may be read
- Advantages
- Least invasive method
- Recommended by AAP for infants (due to home risk of rectal perforation with Rectal Temperature)
- Disadvantages
- Adequate reading requires Thermometer kept within the axilla for 4 minutes
- Least accurate method for detecting fever
- Not recommended for medical facilities to detect fever and on which to base clinical decision making
- One study found Axillary Temperatures were accurate in under 3 months of age
- Interpretation
- Age <5 weeks old
- Rectal = Axillary Temperature + 0.2/week of age (C)
- Age >1 month old
- Rectal = Axillary Temperature + 1 (Celsius)
- Age <5 weeks old
VII. Technique: Core Temperature
- Devices
- Esophageal Thermometer
- Bladder Thermometer
- Advantages
- Most accurate methods of Temperature monitoring
- Disadvantages
- Invasive and used only in specific, intensive indications (e.g. Heat Stroke, Hypothermia)
VIII. Precautions
- Avoid wearable Thermometers and color change strips due to unreliability
IX. References
- (2016) Presc Lett 23(11)
- (2000) Paediatr Child Health 5(5): 273-6 [PubMed]
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Related Studies
| Definition (ICF) | Functions involved in regulating the core temperature of the body. |
| Definition (ICF-CY) | Functions involved in regulating the core temperature of the body. |
| Definition (MSH) | The measure of the level of heat of a human or animal. |
| Definition (CSP) | degree of heat in the body of a living organism, temperature is measure of the average kinetic energy of the particles in a sample of matter, expressed in terms of units or degrees designated on a standard scale. |
| Concepts | Organism Attribute (T032) |
| MSH | D001831 |
| SnomedCT | 276535009, 1942004, 363815009, 386725007, 105723007 |
| LNC | LP65487-8, MTHU001362 |
| English | Body Temperature, Body Temperatures, Temperature, Body, Temperatures, Body, Body temperature observation, body temperature, temperature, Body temperature (function) (observable entity), Body temperature observable, Body temperature observable (observable entity), Body temperature, BT - Body temperature, Body temperature (observable entity), Body temperature - observation, Body temperature finding (finding), Body temperature finding, body; temperature, temperature; body, Body temperature, NOS, Body temperature (function), Temperature (Body) |
| Swedish | Kroppstemperatur |
| Spanish | observación acerca de la temperatura corporal, temperatura corporal (función), temperatura corporal - observación, carcterística observable de la temperatura corporal (entidad observable), temperatura del cuerpo, carcterística observable de la temperatura corporal, hallazgo relacionado con la temperatura corporal (hallazgo), hallazgo relacionado con la temperatura corporal, observación acerca de la temperatura corporal (entidad observable), temperatura corporal (entidad observable), temperatura corporal, Temperatura Corporal |
| Czech | tělesná teplota |
| Finnish | Kehon lämpötila |
| French | Température du corps, Température organique, Température corporelle |
| Russian | TEMPERATURA ORGANA, TEMPERATURA TELA, ТЕМПЕРАТУРА ОРГАНА, ТЕМПЕРАТУРА ТЕЛА |
| Croatian | TJELESNA TEMPERATURA |
| Polish | Ciepłota ciała |
| Norwegian | Kroppstemperatur |
| Dutch | lichaam; temperatuur, temperatuur; lichaam, Lichaamstemperatuur |
| German | Körpertemperatur |
| Italian | Temperatura corporea |
| Portuguese | Temperatura Corporal |
Ontology: Temperature (C0039476)
| Definition (ICF) | Degree of heat or cold, such as high and low temperature, normal or extreme temperature. |
| Definition (ICF-CY) | Degree of heat or cold, such as high and low temperature, normal or extreme temperature. |
| Definition (MSH) | The property of objects that determines the direction of heat flow when they are placed in direct thermal contact. The temperature is the energy of microscopic motions (vibrational and translational) of the particles of atoms. |
| Definition (NCI_CDISC) | The property of a body or region of space that determines whether or not there will be a net flow of heat into it or out of it from a neighboring body or region and in which direction (if any) the heat will flow, perceptible by living organism as a somatic sensation of cold or heat. It is a measure of the average translational kinetic energy associated with the disordered microscopic motion of atoms and molecules. Temperature is measured in one of the three standard temperature scales: Celsius, Kelvin, and Fahrenheit. (NCI) |
| Definition (NCI) | A measure of the average kinetic energy of a system of particles. Temperature may be quantified, in the context of thermodynamics, as the potential of one system to transfer thermal energy to another system until both systems reach a state of thermal equilibrium. |
| Definition (CSP) | a specific degree of hot or cold as indicated on or referred to a standard scale. |
| Concepts | Quantitative Concept (T081) |
| MSH | D013696 |
| SnomedCT | 703421000, 246508008, 102404009 |
| HL7 | TEMP |
| LNC | LP6872-8, LP36617-6, MTHU009008 |
| English | Temperature, Temperatures, Temp, temperature, temperatures, TEMP, Temperature (observable entity), Temperature (attribute), Temperature, NOS, *Temperature |
| Swedish | Temperatur |
| Czech | teplota |
| Finnish | Lämpötila |
| Russian | TEMPERATURA, ТЕМПЕРАТУРА |
| Croatian | TEMPERATURA |
| Polish | Temperatura |
| Norwegian | Temperatur |
| Spanish | Temperatura, temperatura (atributo), temperatura, Temperatura Ambiental |
| Portuguese | Temperatura, Temperatura Ambiente |
| French | Température |
| German | Temperatur |
| Italian | Temperatura |
| Dutch | Temperatuur |
Ontology: Thermometer, device (C0039818)
| Definition (UMD) | Measuring instruments for determining the temperature of matter. Most thermometers used in the field of medicine are designed for measuring human body temperature or for use in the clinical laboratory. Thermometers usually display the temperature in degrees Celsius and/or Fahrenheit. |
| Definition (MSH) | Measuring instruments for determining the temperature of matter. Most thermometers used in the field of medicine are designed for measuring body temperature or for use in the clinical laboratory. (From UMDNS, 1999) |
| Concepts | Medical Device (T074) |
| MSH | D013821 |
| SnomedCT | 27991004 |
| English | Thermometers, Thermometer, device, Pyrometers, thermometer (treatment), thermometer, thermometers, Thermometer, Thermometer, device (physical object) |
| Swedish | Termometrar |
| Czech | teploměry |
| Finnish | Lämpömittarit |
| Russian | TERMOMETRY, ТЕРМОМЕТРЫ |
| French | Thermomètres |
| Polish | Termometry |
| Norwegian | Termometre |
| Spanish | termómetro (objeto físico), termómetro, Termómetros |
| German | Thermometer, Temperaturmeßgerät |
| Italian | Termometri |
| Dutch | Thermometer, Thermometers |
| Portuguese | Termômetros |
Ontology: O/E - axillary temperature (C0437727)
| Concepts | Finding (T033) |
| SnomedCT | 164292006, 141486007 |
| Spanish | al examen: temperatura axilar (hallazgo), al examen: temperatura axilar (categoría dependiente del contexto), al examen: temperatura axilar |
| English | On examination - axillary temperature, O/E - axillary temperature (finding), O/E - axillary temperature, On examination - axillary temperature (context-dependent category), On examination - axillary temperature (finding) |
Ontology: O/E - rectal temperature (C0437729)
| Concepts | Finding (T033) |
| SnomedCT | 164294007, 141488008 |
| Spanish | al examen: temperatura rectal (hallazgo), al examen: temperatura rectal (categoría dependiente del contexto), al examen: temperatura rectal |
| English | On examination - rectal temperature, O/E - rectal temperature (finding), O/E - rectal temperature, On examination - rectal temperature (context-dependent category), On examination - rectal temperature (finding) |
Ontology: O/E - oral temperature (C0555770)
| Concepts | Finding (T033) |
| SnomedCT | 275874003, 141485006, 164291004 |
| Spanish | al examen: temperatura oral (hallazgo), al examen: temperatura oral (categoría dependiente del contexto), al examen: temperatura oral |
| English | On examination - oral temperature, O/E - oral temperature, On examination - oral temperature (context-dependent category), On examination - oral temperature (finding) |
Ontology: O/E - tympanic temperature (C1277660)
| Concepts | Finding (T033) |
| SnomedCT | 315632006, 141491008, 164297000 |
| Spanish | al examen: temperatura timpánica (hallazgo), al examen: temperatura timpánica (categoría dependiente del contexto), al examen: temperatura timpánica |
| English | On examination - tympanic temperature, O/E - tympanic temperature (finding), O/E - tympanic temperature, On examination - tympanic temperature (context-dependent category), On examination - tympanic temperature (finding) |
