Best route of temp for intubated pt

missjennmb · Oct 16, 2008

I was thinking axillary or tympanic as well. Maybe someone with more experience can chime in. We just did our vitals part of Fundamentals a couple of weeks ago, but I guess I could be wrong.

Alternator81 · Oct 16, 2008

That doesn't make any sense. 1st, I would never take an oral temp on an intubated patient because they have a large tube taking up a large portion of the mouth with gauze sponges and straps all around-- not to mention they often are coughing very hard and I would be afraid I could hurt them. As a rule I never take an oral temp unless the patient can hold the probe themselves. When I work as a tech in the ICU, I always take a tympanic temp!

Besides, if anything I would think the temp would less accurate because intubated patients often have there mouth open all day.

PEBBLES1 · Oct 16, 2008

Tympanic temps are done on intubated pt's

healthybee · Oct 16, 2008

Thank you! I thought that sounded strange!

chevyv, BSN, RN · Oct 16, 2008

When I worked Critical Care, we always took rectal temps on pt's that were intubated. We were always taught it was more reliable. Never oral temps.

aerorunner80, ADN, BSN, MSN, APRN · Oct 16, 2008

When I work in ICU, we don't have the option to take tympanic temps so, if I can see the mouth, I take an oral.

When you think about it, the ET tube is on top of the tounge so even though the mouth is open, the tounge is being pushed down into the bottom of the mouth where air cannot get to it to cool it down and alter the temp.

Also I have noticed that intubated pts don't typically cough on their own when they are sedated, only when suctioned and the relfex is stimulated. When they are not sedated, that is of course different and you can ask the pt to open their mouth as much as they can to get a temp (It's very rare that we get intubated pt's that are aware unless they are getting ready to be extubated the same day).

Axillary to me is the most unerliable temp. It can vary if the pt has been moving causing friction or if the pt has been laying down with the arms out, the temp will read lower than normal. I've also found axillary temps harder in elderly emaciated pts. The reason is that the muscle mass has wasted away so much that even when they pull their arms in, there is still a hollow space in the armpit where no skin is touching.

The only time I don't take an oral on a pt who is intubated is if I cannot see in the mouth.

Of course if I had the option to take a tympanic, I would almost every time but where I work that is not an option.