Do you ever see higher axillary temperatures than core temperature?

[bubbalooboo]

I've been told by heme/onc RNs that the axillary temp on a patient is falsely high because she hasn't moved around much and her axillary is just hot because she is immobile. Their justification was that her belly and forehead temperatures were cool so she couldn't possibly be as high as 39C.

My current understanding working in the ICU is that your axillary temp is 0.5-1 degree lower than core and that you can't get a higher temp unless there's manufactured heat (e.g. heating pad, warm air blowing in the area). So realistically, it could be >39. As for the forehead and belly area - the patient has noticeable ascites, is only covered by a thin flat sheet, and is in a cool room so the forehead also would be markedly colder. The patient is also in the last stages with sats sitting at about 82%.

I'd love to put this out there as a survey and to learn something new if my line of thinking is wrong. Not a dismissive post by any means. Love to hear from anyone on their experience

[ruby_jane, BSN, RN]

When last I worked ICU we took axillary and added a degree to it. I have never worked oncology. It is possible that this is the correct wisdom but...would I stake my nursing license on "well, we think her armpits are warm because she's immobile?" Nope.

[Buckeye.nurse]

If I have reason to think a temp is inaccurate (oral or axillary), I'll check the other site and record both temps in the chart. I know of one instance (in all my years of nursing) where a patient's axillary temp was higher than his oral temp by a significant amount. We couldn't come up with a good reason why. The covering service didn't believe the nurse, and came up to the room to check himself before initiating the neutropenic order set. Spoiler alert--he got the same values as the RN

So I guess, when in doubt check another site and report both. For very sick patients, ideally, they have a foley with a continuous temp probe in it. However, it sounds like, based on another part of your post (last stages with an 02 sat of 82%) that a possible temp is no longer the priority here.