Temps

[rondafan]

Now i've only been an RN for 5 years but this is the first time this has ever come up. I had another RN tell me that for a rectal temp you should subtract a degree & for an axillary temp add a degree. So this makes an oral temp THE true temp? I was always under the impression that a rectal temp is the core temp so this is your true reading. Please set me straight on this. We had a lot of opinions on this at work so I told my CNA's to just put where you got the temp from & let me go from there.

[NurseDennie, BSN, RN]

Nooooo -

It's kind of a thing that you keep in mind, but if you take a rectal temp, then you should chart THE TEMP YOU GOT and that it was rectal. (Same thing with PO and ax temps, if they're allowed where you are - chart what you got and where you got it).

You'll find that, in general PO temp is about 1 degree lower than rectal temps and axillary temps are about 1 degree lower than the PO. .

But you should chart and/or report what you GOT. So you did it right!

Love

Dennie

[funnynurse]

what about tympanic temperatures? Any one know if it is a degree higher or lower than oral temps?

[Cali]

I agree with Nurse Dennie. On our unit we always just write the temp and then put an A, O, or R (ax, oral, rectal) behind it.

[NurseDennie, BSN, RN]

I have no idea about the tympannic temps. When the first came out, my kids were still young enough to go to the pediatrician, and the nurses there griped about them no end. I'm sure they've improved technically since then. My guess would be that the temp would be about the same as the PO, wouldn't you think?

But like I said, I am strictly guessing. We've never used them, anywhere I've worked.

Love

Dennie

[sleepyhead]

i've heard with tympanic temps, you're supposed to take it three times and take an average of the three temps to get the most accurate reading.

[P_RN, ADN, RN]

Human bodies don't have strict temperature rules to play by.

If it's oral chart ____ PO

If it's rectal chart ____R

If it's tympanic chart ____T

Some people's temps follow those arbitrary rulas. Most don't

If you doubt the thermometer, go get another one. Otherwise get on with your other 10 patient's vitals.

[askater]

I have found tymphanic on adults very unreliable. I've heard other nurses say that too. Has anyone had better luck with tymphanic than me???

[NurseDennie, BSN, RN]

LOL P_RN. Amen to that!

Love

Dennie

[BrandyBSN]

tympanic temps are "supposed" to be an accurate measure of Core temp, and should match rectal temp...

Having said what they were "supposed" to do, as far as I can tell, no, they dont work very well. I have used about 6 different types between all of the places I work, and the tympanics rarely capture a true temperature reading. I prefer PO or AX.

BrandyBSN

[canoehead, BSN, RN]

We used tympanic temps alot in peds and after getting temps that did not match ANY of the other body sites westarted to think they were pretty inaccurate. So in talking to the company rep found out that the ear must be large enough to accomodate the probe, there can't be wax, or hair or anything obstructing the probe's view of the eardrum, the ear canal must be straight. And in personal experience I have found that if a child is lying on their side the lower ear has a higher temp. If they sit erect for 5 min the two ears generally even out in temps- maybe lying on the ear keeps the heat in? And finally, the rep also said that the ear temp is more representative of what is going on at that moment in the body and that if the child is spiking a fever that the ear temp will go up before the rectal temp does- being closer to the temperature control centre in the brain. So it takes the a$$hole about 20 min to catch up with the ear:rolleyes: And that if there is stool in the rectum all bets are off anyway.......

So we continued taking tympanic temps, but did a rectal when a child was not acting quite right, or when they felt hotter than we thought they should. Really they stink as far as accuracy goes, but are quick, easy to take on a sleeping child and safer and more comfortable than any other way. I think sometimes eyeballing a kid is the best way to tell how sick they are, and feel their forehead - not really a documentable judgement though is it?

[sharann, BSN, RN]

Tympanic temps are not trustworthy due to the fact that the result can almost never be reproduced if two or more individuals take a temp. No two CNA's or nurses will get the same readings, I guarantee it. Also, if the person was talking on the phone, sleeping on one side (as mentioned) or has wax or an ear infection, the temp will be higher by 1 to 2 degrees. That is a large difference. 102 vs 104 etc..

Oral is the closest to accurate as we know it, but axillary works (add one degree) well too especially w/those mouth breathers.