Presentation titlein the Vital Signs TITLE HERE SUB

Ambulatory Setting:
An Evidence-Based Approach

How to Measure Temperature

Cecelia L. Crawford RN, MSN

Temperature Techniques & Methods: An Overview

Temperatures can be different depending on
Type of Thermometer Glass or Chemical Dots Electronic or Tympanic Body Site Oral, Axillary, Rectal, Ear

Type of Thermometer - Glass

Once viewed as the Gold Standard Must be left in for several minutes
Up to 7 minutes for an accurate temperature!

Now associated with adverse events

Rectal or oral trauma Breakable Mercury exposure

Type of Thermometer Chemical Dots

Single use Disposable & inexpensive Axillary, Rectal, Oral Can be difficult to read Long measurement time needed
Up to 7 minutes for an accurate temperature!

Axillary Temperature
Safe & inexpensive Often inaccurate because:
Long measurement time needed Patient must be still Patient must be positioned or held

Not recommended for young children Must document as an axillary temp and NOT an oral temp

Rectal Temperature
Thought to be as accurate as an oral temp Needs lubrication Long measurement time needed May cause rectal trauma & cannot be used with:
Newborns Diarrhea Rectal surgery or bleeding

Patient may be embarrassed Patient must be positioned or held Must document as a rectal temp

Oral Temperature
Comfortable & easy, no positioning needed Accurate temps when proper technique used
Must place thermometer tip in left or right mouth pocket under tongue IS influenced by hot & cold fluids NOT influenced by breathing

Oral Temperature
Long measurement time Should not be used with:
Confused or uncooperative patients Infants & small children Oral surgery or oral trauma History of seizures or chills

Temperature Technology

Automated Temperature Machines

Electronic and infrared thermometers Convenient May save time & labor

Ear (Tympanic) Temperatures

Easy site to use with accurate temps Rapid measurement 2 to 5 seconds!

Uses disposable, single use probes

No interference with breathing Little patient positioning needed Not effected by food, drink, or smoking Can be used with all age groups & most patients
Newborns (no heat loss), infants & small children Useful with confused & uncooperative patients

Ear (Tympanic) Temperatures

Can be affected by heat & cold: Heating & cooling measures Hot packs, ice packs, heating blankets Extreme outside and inside temperatures Air conditioners, overheated rooms Very hot or very cold days Bathing or swimming May need to wait 20 minutes for accurate temp

Ear (Tympanic) Temperatures

Can also be affected by:

Impacted ear wax & ear infections Whether an ear tug is used

Should NOT be used if patient had ear surgery

Ear (Tympanic) Temperatures

What Patients Think About Ear Temperatures
Parents of pediatric patients like them! Fast, easy, clean, and safe Pediatric patients react better! Faster measurement Can stay in parents lap or arms No holding or restraining No positioning

Tympanic Temperature Procedure

1. Wash hands & put on gloves if appropriate 2. Assist patient into a comfortable position
Head turned to side, away from HCW Pediatric patients can be in parents arms or lap

Tympanic Temperature Procedure

3. Remove thermometer from handheld unit
Slide disposable probe cover over probe tip until locked in place Do not touch lens cover Do not apply pressure to ejection button

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Tympanic Temperature Procedure

4. Use correct ear to measure temperature If holding thermometer in right hand, use right ear If holding thermometer in left hand, use left ear
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Tympanic Temperature Procedure

5. Insert covered thermometer probe into ear canal and position properly Children 1 year & older/Adults: Gently pull top of ear back, up, & out Children less than 1 year: Gently pull top of ear straight back Point tip towards nose
Less than 2 yrs: point tip between eyebrows & sideburns

Snugly fit probe tip in ear canal and do not move

Tympanic Temperature Procedure

6. Depress scan button on handheld unit 7. Leave probe in place until a beep is heard
Temperature will appear on digital display screen

8. Carefully remove probe from ear canal 9. Push ejection button on handheld unit to remove probe cover
Place used probe cover in trash DO NOT REUSE!

Tympanic Temperature Procedure

10. To repeat a temperature measurement:
Use a new probe cover Wait 2-3 minutes if using the same ear May use the opposite ear with new probe cover Return handheld unit to thermometer base Tell patient the temperature reading Assist patient to comfortable position Remove gloves & wash hands

11. When temperature measurement is done:

Tympanic Temperature Procedure

Inform RN or MD if:
Very low or very high temperature Normal temp: between 97o to 100o F Ear wax is seen in ear or on probe cover Unable to get a temperature reading due to: Uncooperative patient Confused patient Parent or patient refuses Machine malfunction

Tympanic Temperature Procedure

12. Document the Results
Flowsheet, clinic record, or clinic chart

13. Communicate the Results

RN MD

Temperature Measurement in the Clinic

YOU can make the difference:
Welcoming presence Decrease any anxieties & fears Reassure patients & family Accurate vital signs