Specialties NICU
Published Aug 17, 2003
VickyRN, MSN, DNP, RN
49 Articles; 5,349 Posts
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. I really DO APPRECIATE how much you have helped me with my lectures!!!:kiss
KRVRN, BSN, RN
1,334 Posts
No rectal temps, ever. All axillary.
babylog2012
20 Posts
Why?
NICU_Nurse, BSN, RN
1,158 Posts
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.
Thank you :)
RN-NICU
9 Posts
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.
dawngloves, BSN, RN
2,399 Posts
Axillary. And then teach parents that's the only way they should do it as well.
Jolie, BSN
6,375 Posts
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.
Mimi2RN, ASN, RN
1,142 Posts
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.
Excellent points, all of you!
Jolie, what other methods do you use to check anal patency at birth?
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.