Initial newborn temp. rectal or axillary?

[rainrn12]

Working in a community hospital our policy is to take a rectal temp initially to assess rectal patency. The team from the large regional hospital considers this barbaric. I have looked for evidence based research on both methods and have found none.

What does everybody else do?

And what research, standards of care support your policies?

[Elvish, BSN, DNP, RN, NP]

Our policy is to do rectal/axillary temps together once upon admission, then axillary temps from there on out. I really don't like it.

All the time I see ax temps that are perfectly normal with a low rectal, which can indeed happen if the probe is touching meconium, vs. just the rectum. And I've seen kids pass meconium after a rectal temp but within 24-36 hours are dxed with Hirschsprung's disease. So to me, a rectal temp proves....nothing.

Fortunately, I've never seen an intestinal perf from a rectal temp. I hope that trend continues.

[rn/writer, RN]

We do axillaries from birth on unless we get a seriously out-of-range reading. Then we will do a rectal temp with great care. I prefer not to do these in front of parents. Don't even want a visual suggestion that they should do it this way. If they ask about rectal temps, I stress that they should speak with their doc/ped and only do rectal if practitioner says to. I tell them there are risks with rectal that can be avoided with axillary.