Temperature. Where do you go?

Bottom is worst. Properly positioned esophageal probe (at the aortic arch) will give you the closest match and the fastest response to blood temperature changes.

We take axillary on patients unable to otherwise take oral temps on (so pretty much everyone). Very rarely have esophageal probes. Never taken a rectal, but a lot of our patients are transplant (inc bowel) and the team would flip!

We go by Foley or Rectal. Although the other day we didn't get as far down as rectal (without turning) and we decided lady partsl was hopefully just as good. A lot of our patients have either SG's or PICCO systems so we'll measure on those as a first choice. I know that the OR used to experiment with nasal temperature but that never made it next door to the ICU. Some of my colleagues go by continuous axillary or femoral fold (on the obese patients) but I fail to see the point of going there for continuous measurements (other than saving 15 seconds taking an intermittent temp):

A) I wouldn't want a rectal probe under my arm even with a cover, knowing where it has been.

B) If a patient minds having something stuck up a hole they can probably go intermittent temp monitoring as well and complain when they are hot or cold ^^.

C) They dislodge every chance they get and start registering 23 °C room temp and I have to manually fix all the faulty data until I can replace the probe.

I have had cooling patients in both the NICU & peds cardiac ICU. In NICU we use esophageal probes and in CICU we use rectal. Not sure why there is a difference between the units. In any case its the same probe & set up (and a new probe for every patient of course). Maybe rectal is easier because you don't need xray verification for good positioning. I don't know.