How do YOU check a temp in an orally intubated person?

[JoshuaAdamsRN]

Ok, here's the scoop. Friday morning I was giving report to the ICU nurse on this grandma who came in extremely short of breath and we ended up tubing. I thought that I had given an EXCELLENT report. I told her that this lady had a fever of 39.2 and I had given rectal Tylenol. Then she asked me what the repeat temp was, and I said I hadn't checked one because no one was able to help me roll her and get a rectal. The ICU nurse said, really snarky-like, "What, you can't do oral temps down there?" I asked her to repeat her question, and she replied "Oh never mind, just bring the patient up."

Now, I've been checking my books and I haven't come across anything saying that you couldn't get an oral temp on a patient with an endotracheal tube, but I always thought it was standard to get a rectal as it would be more accurate. Am I way off base? It seems like you can do a thousand things the right way, and the ICU always acts like intelligence is altitude based - we're complete idiots in the ER because we're on the ground floor and they became ICU nurses and work on the 7th floor because nuclear astrophysics wasn't challenging enough for them.

[sofaraway04]

I've probably taken an oral temp about 2 times ever. everywhere I've been as a student or worked has used tympanic thermometers. they are easy to use and i've never had a problem with accuracy, apart from a couple of pateint who had very blocked ears from wax.

[ERJUNKIE4LIFE]

Thanks I've been trying to find that article again.

[cardiacRN2006, ADN, RN]

I use oral on intubated pts who don't have a foley/esophageal temp probe.

If the mouth is dry or one that won't close, then I do axillary.

I've had rectal temp probes before, but otherwise, I find no need for a rectal temp.

Would never rely on tympanic. Just based on 10 years of being a tech, and finding that the results vary too widely for my comfort.

[scattycarrot, BSN, RN]

Would never rely on tympanic. Just based on 10 years of being a tech, and finding that the results vary too widely for my comfort.

I agree with you! They are particulary inaccurate when the patient has come in from the outside or has been waiting in an cold waiting area. Now obviously this doesn't matter with your intubated patiients in the ICU but when you are at triage, it is an important point to remember. I have seen other nurses document patients as hypothermic when actually they are nice and warm to the touch!

[S.T.A.C.E.Y, LPN]

The ER I work in only really uses tympanic thermometers. Theres a few rectal things for continuous monitoring in one of the drawers, but they've got alot of dust on them. I have yet to see a regular oral or rectal thermometer, and never a foley one. Funny, 'cause at the last ER I did clinicals in they absolutely refused to use the tympanic unless it was a last resort b/c they felt very strongly about its inaccuracy.