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Body Temperature
Aka: Body Temperature, Temperature, Rectal Temperature, Oral Temperature, Tympanic Temperature, Axillary Temperature
- See Also
- Fever
- Heat Illness
- Hypothermia
- Vital Signs
- Pediatric Vital Signs
- 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
- 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
- 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
- Technique: Forehead or temoral Temperature
- Procedure
- Infrared device placed over temporal artery distribution region
- Advantages
- Fast and simple
- Disadvantages
- Most expensive of thermometers
- Error prone
- 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
- Shann (1996) Arch Pediatr Adolesc Med 150:74-8 [PubMed]
- Interpretation
- Age <5 weeks old
- Rectal = Axillary Temperature + 0.2/week of age (C)
- Age >1 month old
- Rectal = Axillary Temperature + 1 (Celsius)
- Technique: Core Temperature
- Devices
- Esophageal thermometer
- Bladder thermometer
- Advantages
- Most accurate methods of Temperature monitoring
- Disadvantages
- Invasive and used only in specific, intensive indications
- Precautions
- Avoid wearable thermometers and color change strips due to unreliability
- References
- (2016) Presc Lett 23(11)
- (2000) Paediatr Child Health 5(5): 273-6 [PubMed]