How do you measure temperatures?

[EMSnut45]

The unit that I work in is a mixed ICU. We currently measure temps axillary-- which literature says is inaccurate. We have trialed tempanic thermometers with very iffy results. Some of the other units in the hospital use temporal thermometers, and staff complain of inaccurate results with them as well.

We are looking to change our practice, and are willing to spend money.

My vote is to do esophageal temps on the monitor for all intubated patients, and do oral temps on non-intubated patients. What do you think?

How does your unit measure temperatures?

[Teleflurry, DNP]

Tympanic works fine.

Bladder or rectal for PTs on cooling blanket.

[Maghunter]

I was a CNA before starting in the ICU a month ago. I've taken a lot of temps. In my experience ALL the noninvasive temp methods... axillary, oral, tympanic, temporal...have drawbacks and can give false high/low results at times. We use temporal, but if it's not correlating with what I feel or is a little high/low, then I use a secondary method.

[ICUenthusiast]

Temporal for non post surgical patients; some critical patients will get foley temps. Temporal has always worked pretty well.. can tell if it's off and verify with classic oral temp.

[reisling]

I like the groin. Find is is pretty accurate and easy to do.

[divaRN*]

We use temporal temps. I have never seen a bladder temp used. Will also use rectal temp if on a cooling blanket or temp off a swan if they have one. Personally I do not a fan of temporal temps mainly because no one uses them accordinly to manufacturer instructions. Clean with alcohol before use, let air dry... In reality there is no time for this. Manufact. also suggested cleaning probe daily. But again who is responsible for this? what shift? I will clean my probe if the reading seems off. However I feel most RNs or CNAs do not remember the short 5 minute inservice we had (dont blame them). They also have to be used in a specific way. I have seen RNs and CNAs not use them properly (ie. not behind earlobe, dont swipe accross forehead etc..) Too much margin of error, but accurate if used CORRECTLY. I feel this method if good but there needs to be a lot more teaching!

Funny story from my med/surg days: I was told in report that the thermometer in the room was not working (temp too high) and to use the portable one (normal reading). I walk in, use the one in the room (and was told by pt and family it doesnt work), got reading of 107, used portable one with another reading of 107. The pt was A+Ox3 and chatting with me. (I was shocked, asked her if she felt okay). Then I felt her. BURNING UP. Immediatley ordered cooling blanket (rectal probe showed 106), called MD etc. Pt ended up being septic, emergency surgery in the middle of the night, transfer to ICU at end of shift. PERFECT example of how easy it is to use temporal thermometer improperly. Thankfully pt was okay.

[funkywoman]

I have dealt with many ways, obviously core temp is best, with CO or rectal or bladder. My first job at one point we got new Tympanic thermometers and did our own pilot study and we were to use the tympanic thermometer as well as any other way we chose to take temp (bladder, CO, rectal, oral or whatever you had available) and did a comparison. The end result was the tympanic was not accurate and we sent them back to the manufacturer who recalibrated them and sent them back and they worked fine after that.