I am currently finishing my RN. I have worked as an LPN for the last 5 years. In the office where I work we see a ton of ill children and I have never taken a rectal temp. Currently I am doing clinical hours at a different hospital and rectal temps are done on anyone who cannot or will not have a oral temp done. So I guess my question is, are rectal temps done frequently at most facilities. I disscusses this with our local NICU docs and was told the risk out weighs the benifits, so I am just wondering how this are done else where. Thank you for your input.
Mar 1, '12
Rectal temps are the "gold standard" in pediatrics but, for obvious reasons, they are used (at least in my experience) relatively infrequently. I check a rectal temp if there is question as to the accuracy of a reported temperature. For example, I have had patients with temperatures of 33 degrees Celcius on a tympanic thermometer... in that case, no question, the rectal thermometer comes out.
When taking a temperature, it's always my preference to do an oral temp unless the patient is too young or it's not appropriate because if his/her developmental level. (Have had teenagers with autism break the probe by biting through it.) Second is axillary for babies/toddlers. My facility does not have temporal artery thermometers and I don't find tympanics to be particularly accurate.
A significant percentage of our patient population cannot have rectal temperatures taken because of immunosuppression due to chemotherapy.
Mar 21, '12
We do not take rectal temps on the postpartum unit I work at. Axillary is the mode of choice and is deemed accurate. A rectal temp is done at birth to verify patency of the anus.
Mar 26, '12
Here it's seen that rectal temperature's risk's outweigh the benefits. Considerably bowel perforation.
However it is true like KelRN said, rectal temperature does get the most accurate core temperature.
So we have policy that rectal temps are not to be done unless by a paediatrician. We had a locum Medical officer doing it down in Emergency for a while, it caused all sorts of drama's and thus the policy now.
We use axillery in neonates and mini tympanics/axillery in those greater than six months. Normal tympanic in teenagers and up. Oral temperature is outlawed in our ward due to our Infection Control people, I do think oral temperatures are more reliable than the tympanic however.
Mar 30, '12
In the emergency room setting "core temperatures" are much more frequently done. People are coming in form the cold, or hear, that with environmental over exposure can cause an inaccurate temperature with any method with the exception of a core temp....... whether it is urine(bladder), rectal or blood. Another frequent use of core temperatures is with the induction of hypothermia post arrest. So yes, rectal temperature temperature are used in an acute care setting although much more common in critical care areas.
I am curious....you mentioned that rectal temperature on all patients that cannot or WILL NOT do an oral temp. I advise caution in "forcing" temperature rectally unless they are small and incapable of an oral temp. You just can't flip an adult over and pop a thermometer into their bottoms. I am sure that is not what you are doing but your wording struck me odd. Just look at this as the disclaimer "what you are about to see performed are by highly trained individuals....please do not try this at home."
Mar 30, '12
Where I work we only have tympanic thermometers available.
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