Which temp is more accurate Oral vs Tympanic??

[SonorityGenius]

Hey everyone,

So I am in midst of an arguement at work between a CNA and a new grad RN over which temp is more accurate Oral or Tympanic.. now I know different variables come into play using both i.e with oral pt may have drank something cold or hot or with tympanic laying on one side on pillow can cause false highs etc etc so lets assume no such variables are in play - which temp would be most accurate?

[Okami_CCRN, BSN, RN]

Nothing beats a good old rectal temperature. However, we use tympanic thermometers in my ICU and they are horribly inaccurate apparently my temp is 93.4 and I somehow find that hard to believe. I would say Oral is more accurate.

[JDZ344]

Tympanic is good for speed. Oral is better, IMO. We have both at our place, 9/10 I use oral if the person is able to hold it in their mouth without spitting it out.

[Esme12, ASN, BSN, RN]

Core temp.....rectal. I too have seen studies that due to the variances in tympanic temps due to user error....oral.

[Circejane]

Oral. Tympanic is hit and miss. I once had a 104 temp (had mycoplasma pneumonia) which the tympanic read as 99. I've seen similar inaccuracies in practice many times. IMHO, tympanic is only good when you are trying to get a temp on a squirming toddler, and you're not getting it any other way.

[PediNurse3]

I will not use a tympanic thermometer...they are horribly inaccurate. Oral temps have always been much more accurate in my experience, but even with those, it can vary depending on the placement of the probe.

[CoolhandHutch, MSN, RN]

In my experience, in order from most to least accurate: mom's hands, foley, rectal, oral, tympanic, forehead scanner doohickie...those things suck.

[nerdtonurse?, BSN, RN]

Tympanics are "supposed to" be more accurate since the are closest to seeing the temp of the brain, which is what you're concerned with -- brain cells are sugar based, you get them too hot, the connections between the brain cells melt, and meaningful signals from the brain to the body get scrambled. Then you get seizures, etc.

Having said that, things like ear wax, wide openings to the ear that allow air in to artificially cool the tympanic membrane (and I would think anything that would sclerose the ear drum, damage to it, scar tissue, etc.), would mess it up. If I really need that number, I go for a rectal temp.

FYI -- I'm always one degree higher in one ear than the other (even had my doc check out my ears to see if he could see anything -- nope). So either half my brain's running hot, or these things just aren't accurate.

[cherrybreeze, ADN, RN]

I believe oral temps are more accurate. I know for me personally, tympanic readings ALWAYS run high....I have a temp of at least 100 at all times, according to them (no matter how/when I use them), so I don't trust tympanic temps whatsoever.

[Girlygirl69]

Oral temp

[JustBeachyNurse, LPN]

When my son was about 4, he had a raging ear infection, his tympanic in the infected ear was 107F+ (which totally freaked out the MA in the office). I don't remember if she even checked the other ear. The RN came in, and since he was somewhat exhausted we got a successful rectal temp (103.5F) which was more expected.

Neither the nurse nor I panicked at the 107F tympanic, frankly he didn't look THAT sick. She just rechecked the number. The MA was trying to convince the receptionist to call 911.

When I did clinical research, tympanic temps were used for screening, oral was considered more accurate. In fact, by the time I left nearly every protocol required an oral temperature and specifically excluded tympanic.

[SummitRN, BSN, RN]

Tympanics are good for trends, not absolute numbers.

Old WEMS joke: pen makes a good rectal thermometer. If you can get that close to your patients rectum with the pen, they have hypothermia or hyperthermia