rectal temps

Rectal temps are the "gold standard" in pediatrics but, for obvious reasons, they are used (at least in my experience) relatively infrequently. I check a rectal temp if there is question as to the accuracy of a reported temperature. For example, I have had patients with temperatures of 33 degrees Celcius on a tympanic thermometer... in that case, no question, the rectal thermometer comes out.

When taking a temperature, it's always my preference to do an oral temp unless the patient is too young or it's not appropriate because if his/her developmental level. (Have had teenagers with autism break the probe by biting through it.) Second is axillary for babies/toddlers. My facility does not have temporal artery thermometers and I don't find tympanics to be particularly accurate.

A significant percentage of our patient population cannot have rectal temperatures taken because of immunosuppression due to chemotherapy.

We do not take rectal temps on the postpartum unit I work at. Axillary is the mode of choice and is deemed accurate. A rectal temp is done at birth to verify patency of the orifice.

Here it's seen that rectal temperature's risk's outweigh the benefits. Considerably bowel perforation.

However it is true like KelRN said, rectal temperature does get the most accurate core temperature.

So we have policy that rectal temps are not to be done unless by a paediatrician. We had a locum Medical officer doing it down in Emergency for a while, it caused all sorts of drama's and thus the policy now.

We use axillery in neonates and mini tympanics/axillery in those greater than six months. Normal tympanic in teenagers and up. Oral temperature is outlawed in our ward due to our Infection Control people, I do think oral temperatures are more reliable than the tympanic however.