taking temperatures?

truern · Nov 17, 2004

we always use axillary....

i haven't seen a rectal temp is some time.

Pediatric Critical Care Columnist · Nov 17, 2004

We do mostly rectal temps on critical kids using a rectal probe. We are also expected to do intermittent rectal temps on our stable kiddies under about 5, or until we can expect them to cooperate with oral temps. Axillary temps are a rarity. As an aside: In kids under 2 tympanic thermometers are very inaccurate. In fact, they're very inaccurate in most instances because positioning the sensor correctly is so difficult. I took my 12 year old in for day surgery and the admitting nurse checked his tympanic temp... it was 35.3 C and an absolute impossibility. I repeated the temp holding the thermometer in the right spot and gee... it's actually 36.8 C. I wonder how many kids are febrile and not being picked up pre-op in that hospital?

uk_nurse · Nov 18, 2004

we use tempa dots.... u just put them under the arm, parents or urself if parent not there gently hold arm down. we do not force arm down...then read dots and throw away, very easy to do. we never do rectal unless absolutely necessary. i have never done one.

in older childrenthey can be placed in the mouth, under the tongue

Dragonfair · Nov 22, 2004

We used temp dot also in Ill. Work really well. Don't have the hassle of holding the prob.

Trauma Columnist · Nov 22, 2004

I work ER and we do rectal temps on ALL ill kids under the age of 5 or 6 - depends a little bit on their cooperation. We NEVER do axillary temps. It seems to me that if a child is hospitalized an accurate temp needs to be assessed. What is the reasoning behind use the axillary temps? I'm not criticizing, just curious.

purplemania, BSN, RN · Nov 22, 2004

we NEVER do rectal temps unless ordered by MD (and that is usually a one-time thing). There is no need to traumatize the child physically or emotionally when the information can be had much simpler.

purplemania, BSN, RN · Nov 22, 2004

I forgot to add that tympanics are not used by our nurses on the floor, although the ER does them. The probe is too big for most kid's ears, and too many people were touching the outer ear, thinking they had the probe in far enough. Again, we find the axillary easy and reliable. Still requires good technique though.

Dragonfair · Nov 22, 2004

We use a little sticker that is placed on the side of the child just about straight down from the nipple line midway from back and front. It is not under that axilla. We get a direct temp of the body. We get away from the possiblity of ruptures or fistulas from the props,cause kids move so much. Susan

I work ER and we do rectal temps on ALL ill kids under the age of 5 or 6 - depends a little bit on their cooperation. We NEVER do axillary temps. It seems to me that if a child is hospitalized an accurate temp needs to be assessed. What is the reasoning behind use the axillary temps? I'm not criticizing, just curious.

Loving Life · Nov 23, 2004

I work ER and we do rectal temps on ALL ill kids under the age of 5 or 6 - depends a little bit on their cooperation. We NEVER do axillary temps. It seems to me that if a child is hospitalized an accurate temp needs to be assessed. What is the reasoning behind use the axillary temps? I'm not criticizing, just curious.

We do axillary temps on all heme-onc patients, rectal on those 2 yrs and under. Over two years, you do have the psychological aspect. We never do a rectal on an abuse child or heme/onc.

truern · Nov 23, 2004

At UNC Childrens Hospital in Chapel Hill were I did my peds rotation, it was axillary for every patient I had....except one 16 year old :)

At Wake Med where I'm doing my labor and delivery rotation, it's axillary on all the newborns. If I'm not mistaken, they use axillary on peds there, too.

I don't know about the ED at those hospitals, though.

kotys · Nov 25, 2004

what are the guidelines for taking temps for children under 2 years? Do you always use rectal or will tympanic or axillary do?

Our guidlines at WVU children's hospital are for all under two must have a rectal temp unless they are neutropenic or an order must be obtain not to. I.e. bowel issues. We also did a study on tympanic themometers and they were shown to not be accurate in children under 1 yr due to anatomyand too much room for error.

Shannon