Temps in the ER

I'm fortunate that my hospital has foley catheter temp probes that plug into the monitor. If only someone could come up with something that reads blood sugars on the monitor, I hate doing finger sticks!!!

Hello all,

I was at a hospital training session the other day and the ED nurse educator made a comment about how we're (ER nurses) are really good about keeping up with vitals, but really bad when it comes to temps. In most instances, the patient's temp is checked at triage and that's about it. I, personally, only recheck temps if the patient was febrile and I administered Tylenol and am doing a follow up or if I notice a change in skin temp (or other obvious factors). Just wondering about the practices of the other ED nurses on this board when it comes to rechecking temps?

Also, does anyone else use the temporal thermometers? I like them because they're easy to use and are said to be an accurate reflection of core temperature when used correctly, however, I still go for a rectal temp for a real-real reading.

Thoughts and opinions are appreciated!

Cheers!

I agree with your thought process, I do the same. You can never go wrong with a rectal temp. for a true reading. Must be a QA thing.

We check temperature with our routine vitals. We have temporal thermometers and rectal for infants under 6 months.

I'm in the same camp as you. VS at triage, and unless the temp is elevated or low, I usually won't re-check it. If we are holding the pt in the ED for an extended time, I will get one q6h. We use oral/rectal temps...I wish we had temporal/tympanic!!

do you mean you get a Tympanic? I only get temps, personally, like you said, if they were febrile, given Tylenol/Motrin, etc., otherwise a temp is not included in my *supposed* to be q2 hour vitals. The nursing techs will do temps q 2 hours though.

Same as you! We check at triage and then only recheck if it was abnormal. Our educator doesn't seem to mind.

Seems like many of you do the same thing as us. Do you think this warrants further research in the area and maybe a change in policy? I'm not much of a fan of changing/creating policies with no purpose, but maybe there's a chance it could lead to better outcomes. I'm only per diem at my hospital and in no shape to start doing unit based research, but maybe some of you evidence based nurses out there could start something and eventually get published in the JEN (and adding a special thanks to LegZRN ).

Triage checks the temperature and unless they've been running a fever we don't re-check it as routine.

We/I seem to be lax on temps too, and if it's not up in triage, and there's no reason to suspect a temp, it's usually not done again.

We only have oral thermometers, and I'd love to have a few tympanics. I used to work where they used temporals and found they were frighteningly inaccurate, even when used properly. My record was 98F temporal vrs 104F rectal. BIG difference!

We/I seem to be lax on temps too, and if it's not up in triage, and there's no reason to suspect a temp, it's usually not done again.

We only have oral thermometers, and I'd love to have a few tympanics. I used to work where they used temporals and found they were frighteningly inaccurate, even when used properly. My record was 98F temporal vrs 104F rectal. BIG difference!

We really only use the temporal meters in triage and when you're consistently getting patients with a temporal (supposedly core) temp of 96.6F, I'm thinking no.

Agree w you, canoehead. Have seen ridiculously off values from the temporal scanners, and just wide variability in general. But I feel almost the same about tympanic, the results just seem to vary greatly. Some of this I am sure is technique by the various users....even w/ the tympanic ones they have to be seated in the ear canal just right in order to get the most accurate reading. I retake all triage temps if one of these two methods were used (unless I have zero reason to be concerned about it whatsoever).

What brand temporal thermometers have you all used? That's pretty much what we use exclusively. There are disposable oral thermometers we give to parents who bring their kids in for a fever who can't tell us what the fever was, and I think we have one or two machines floating around with a reusable oral on it that works sloooooooooowly. So slow that if that's what I'm using I've often given up and gone in search of the temporal thermometers.

What sort of sheath are you using on them? Are you cleaning the sensor frequently?