temporal Artery Thermometer and Peds in the ED

MissJoRN, RN · Apr 1, 2006

I'm not in the ED but we do use these in peds homecare a lot. I'd be very open to having them on the floor. I think rectal will always be the gold standard for peds and sometimes the only way to go but I think temporal would be more than adequate for traige, etc. My anectodal experience is that temporal is more accurate and consistant than axillary or tympanic. For what it's worth, I trust it enough to be getting one for my baby-on-the-way, although I haven't used one yet in a kiddie under 4. I see no reason that it wouldn't be trustworthy in a baby, at least not after a few months when they're able to thermoregulate.

I think this may be the only time it's come up before- Taking an infant's temp. (on the OB board)

https://allnurses.com/forums/f35/taking-infants-temp-141055.html?highlight=temporal

someone mentions their hospital using them in ED

vamedic4, EMT-P · Apr 1, 2006

You all:
I've been reading some articles and talking to some ped RNs. They plan on starting using Temporal Artery Thermometers instead of Rectal temps. ENA has come out and said the rectal temp is the gold standard for Peds less than 2 years of age. I am trying to improve our triage times and throughput, every little bit will help. IN fact, many of our Peds parents actually get upset when we ask them to disrobe the child, because their Pediatricians use Temporal Artery Thermometers in their offices. Anybody out their using this for Peds? The ED Management and ED Docs won't budge on this until the American Academy of Peds condones it. Our we behind the power curve on this?

I know they use the temp. artery thermometers in our ER at Children's in Dallas - they haven't made it up to the floors yet.

Have a great day.

vamedic4

PedsER-RN, BSN, RN · Apr 1, 2006

you all:
i've been reading some articles and talking to some ped rns. they plan on starting using temporal artery thermometers instead of rectal temps. ena has come out and said the rectal temp is the gold standard for peds less than 2 years of age. i am trying to improve our triage times and throughput, every little bit will help. in fact, many of our peds parents actually get upset when we ask them to disrobe the child, because their pediatricians use temporal artery thermometers in their offices. anybody out their using this for peds? the ed management and ed docs won't budge on this until the american academy of peds condones it. our we behind the power curve on this?

we do rectals on babies 3 mo. unless there's a clinical indication that the child needs one.

TraumaLPN · May 10, 2006

My rule of thumb is rectal temps on all pediactric and geriatric pts. who can't PROPERLY hold a themometer in their mouth. We have the temperal scan themometers but I have found them to be very inaccurate. ie. 80 yr old c/o cough with a scan temp of 97.7 but a HR of 114, an oral/rectal temp shows a temp of 102.4, or a 3 yr. with a 99.9 scan temp with a HR of 156 and hot to the touch with a rectal repeat temp of 104.6. One of my biggest pet peaves are triage nurses that use the scan and it reads under 100.0 but the pt. is tachycardic. So I get to do a rectal temp and medicate the pt. for fever when it should have been done at triage. Elderly pts. will fool you, they will be cool to the touch but can still be running a 103.0 temp. Also if you see a scan temp on a kid of 99.8 and the heart rate is 150 you will always find that the pt. has a high fever when you do a rectal temp. So watch your pulse rate.

rnsrgr8t · May 10, 2006

We use the temporal thermometer in our outpatient clinic. I definitely think it is more accurate than the tympanic ( I hate those) but I have noticed that they tend to run a little high. We have been getting a lot of 99-100 degree temps that are normal when we take it by mouth. I had a bundled up newborn yesterday that was read at 100.6 (can be scary at that age) that was really 98.7 when taken regularly. If it is cold out and the have had a hat on etc, you may get an artificially high read. Just something to think about.

**canoehead, BSN, RN** · May 11, 2006

At our ER the temporal artery thermometers were bought, but within a year some docs will not accept their temps. they have been off as much as 4 degrees on children and adults. I wrote to the company for suggestions on how to use them more accurately without any improvement. Personally I do better guessing the temp with a hand to the forehead then the Ta thermometer. If there is any reason to suspect a fever we do a rectal on kids.

allnurses Guide · May 11, 2006

We had an inservice on Temporal Artery Thermometers yesterday. The company rep did his little talk and then tried out the therms on each of us. My temp was 100.4. :confused: Tried it again - 100.2.

I went back to the nurse's station and took it orally. (I had had nothing to eat or drink for over an hour). My oral temp was 98.1. :confused:

So, my first experience is that it wasn't very accurate - I realize it is supposed to measure core temp . . .but that is a big variation to me.

We do rectal temps on infants and peds in the ER and on the floor.

steph

TraumaLPN · May 11, 2006

Bottom line rectal and oral temps are the most accurate. And personally I feel it boils down to how good your nursing skills are. If you will accept a 99.9 scan temp on a 3 yr. old that has a HR of 160 and ignore that there is probley a fever going on ,you will ignore an 80/40 BP in an adult pt. Vital signs are an important tool to determine what is going on with a pt. and temp is an important vital sign. This happened just the other day.....one of our new nurses came and got me because her nursing home pt. had a HR of 138, was cool to touch and scan temp was 98.2. She was concerned that something cardiac was going on. I did a rectal temp and it was 102.7. That HR and the temp both returned to normal with some tylenol. The pt. was uroseptic.