Yet ANOTHER Question...

Specialties NICU

Published

Specializes in Gerontological, cardiac, med-surg, peds.

What is your policy on rectal temps with newborns? If they are healthy, once a shift? Once at birth, and the rest axillary? Thanks for your imput.:D I really DO APPRECIATE how much you have helped me with my lectures!!!:kiss

Specializes in NICU.

No rectal temps, ever. All axillary.

Why?

Specializes in NICU.

We check anal patency at birth but otherwise stay away from there due to the risk of damaging sensitive tissue. We do axillary temperatures on all of our babies- in the NICU (vs. Level I) it varies depending on hospital policy- of course if the MD orders more frequently or the baby has temperature instability issues, we will do it as frequently as we have to. Usually, though, it's with every hands-on assessment. How often hands-on assmt's are done varies from place to place.

Specializes in Gerontological, cardiac, med-surg, peds.

Thank you :)

Axillary temps only.

We do rectal temperatures once a day which of course varys due to the instability but as all our very lil' ones have ISC-(temperature)probes ehich are connected to the isolettes we have control about it 24h. We found that it's more uncomfortable for the babies to take temperature axillar so now we use special thermometres for prematures which have a soft gum at the end. Difficult to describe but it's like a feeding tube though a bit softer.

Axillary. And then teach parents that's the only way they should do it as well.

Specializes in Maternal - Child Health.

We had an otherwise healthy full-term newborn transferred to us for surgical repair of a perforated colon that was determined to be caused by an inappropriately placed rectal thermometer. I never want to see that again. There are other ways of checking anal patency, and much safer ways of taking temps. I also instruct parents to never take a rectal temp.

Specializes in NICU.

The first temp is rectal, after that, always axillary. Reason being we do not want to cause vagal stim, which in turn could cause bradycardia.

Specializes in NICU.

Excellent points, all of you!

Jolie, what other methods do you use to check anal patency at birth?

Specializes in Maternal - Child Health.

Many babies will have already passed meconium prior to their initial newborn exam. No question of patency there.

Some docs prefer to allow a newborn 24 hours to pass a stool before becoming concerned about patency, as long as there is no reason to suspect otherwise.

For those who want to establish patency with the initial exam, or for those babies who we have reason to suspect problems, we generously lube up the tip of a cotton swab, and insert it just far enough to see if it goes in. The key is to hold the baby's legs securely so that there is no sudden movement which could cause the swab to be inadvertently inserted too far. There is no need to leave the swab in place for a couple of minutes, as would be the case with a rectal temp. This method seems to be less distressing to the babies.

+ Add a Comment