Newborn Rectal Temps

[justme1972]

Just curious on something.

I did an OB rotation this week and it was the first time I saw a baby being born. Birth was uneventful.

They were showing us how to do an assessment/monitor on a newborn and of course, one of the major assessments was VS every 30 minutes.

What I noticed is that they took a rectal temperature each time...this baby had about 6 altogether. Done with a probe with a cover.

One of our ATI books said that you don't do a rectal temp on a newborn.

Just wanting other's

[CT Pixie, BSN, RN]

We were also taught and it was in the book that you don't take rectals on newborns.

Not a nurse yet, but when I did my OB rotation, all the newborns vitals were taken according to the protocol times but they did axillary temps, never rectals.

I also recall my newborn daughters vitals being taken frequently and they never took rectals on them either.

[2bRnKim]

I am also in the middle of my ob rotations and I have been to two different hospitals of which neither of them have done rectal temps on newborns- only under the arm.

Kim

[Jolie, BSN]

Some hospitals still do an initial rectal temp to assess the patency of the orifice. Although I disagree with that policy, it is only one rectal temp, and in my experience has been done with the infant's own rectal thermometer, which has a tiny bulb that is unlikely to damage the anal tissue. I shudder to think of a baby having multiple rectal temps taken with a probe cover, as they are larger in size. Also, on a rectal thermometer, the bulb is quite small and easily visualized as the point at which insertion should stop. With a probe cover, there is no marking that is easily visualized, and I am concerned that a probe could easily be inserted too far. Which brings me to my reason for opposing "routine" rectal temps: I cared for a baby whose intestines were perforated by a rectal thermometer inserted too far. He was an otherwise perfectly healthy newborn who got a trip to the Level III NICU for surgical repair.

In my opinion, there is nothing wrong with waiting for passage of meconium stool to assess patency. Most babies are fed prior to their initial assessment anyway, so the argument that it is better not to feed the very rare baby with an imperforate orifice doesn't hold much water with me. If there is a question, patency can easily be assessed by use of a soft, flexible feeding tube that is unlikely to cause damage to the intestines. And axillary temperatures are perfectly accurate and usable, even for sick and septic babies.

Stepping off my soapbox now :)

[JenniG48]

We were taught that taking the temp axillary was the preferred method. I've done OB clinical rotations is 3 hospitals and all 3 took the temp axillary. One of the hosp has a policy for suctioning all newborns, they would check for orifice patency using the suctioning tube after suctioning. The other 2 hospitals wait for BM to check for patency.

[Jolie, BSN]

d method. I've done OB clinical rotations is 3 hospitals and all 3 took the temp axillary. One of the hosp has a policy for suctioning all newborns, they would check for orifice patency using the suctioning tube after suctioning.

What??? Who comes up with these ridiculous policies???