Where do you take temps??

[KittyLovinRN]

I work in a critical care area, we have an intensivist who blew his lid one day when he saw some of the nurses were doing axillary temps and insisted that they ALL be temporal or oral. This just baffles me because EVERY time I take a temporal temp (swipe across the forehead and tap behind the ear) it's around 96F...how can this be more accurate than an axillary? Times where I would use an axillary vs. oral (previously) would have been if the pt were just drinking coffee/water but I feel like no matter what, the temporal is never accurate.

What do your hospital/units do?

Thanks! :)

[Five&Two Will Do]

We have those thermometers here too. I don't notice that they are generally lowr than other methods though. At what point in the process are you letting go of the button?

[caroladybelle, BSN, RN]

I can fully understand why the MD does not care for axillary. It is definitely not optimal.

Temporal - you really have to use very good technique to get an accurate reading and very few people do get taught the proper technique.

I work with severely pancytopenic pts which has bearing on how we obtain temps. Oral is preferred, axillary is second. If they are critical, and require a foley (rarely placed except in CC pts d/t neutopenia), we place a temp probe, by far more accurate. No temporal or tympanic available. And rectal is NEVER permitted (along with enemas and most suppositories) d/t risk of bleeding/infection.

On most other units, rectal or oral is preferred by the MDs for accuracy, though fat chance on getting most adults to permit a rectal temp. Axillary is frowned on.

[KittyLovinRN]

We have those thermometers here too. I don't notice that they are generally lowr than other methods though. At what point in the process are you letting go of the button?

I press the button, place on pt's forehead, swipe, life probe while still holding button and tap probe behind ear, then release the button...am I missing a step?

[spongebob6286, BSN, RN]

we do it oral under the tongue

[NurseLoveJoy88, ASN, RN]

I use a temporal. I have one that does not require the swiping across the forehead. It is pretty acurate. I use this when working with kids or confused elderly. They don't have the patience to do oral or axillary.

If I'm working with someone AOx3 them almost always use oral.

[loriangel14, RN]

My whole hospital uses tympanic (in the ear)

[Forever Sunshine, ASN, RN]

I can fully understand why the MD does not care for axillary. It is definitely not optimal.

Temporal - you really have to use very good technique to get an accurate reading and very few people do get taught the proper technique.

I work with severely pancytopenic pts which has bearing on how we obtain temps. Oral is preferred, axillary is second. If they are critical, and require a foley (rarely placed except in CC pts d/t neutopenia), we place a temp probe, by far more accurate. No temporal or tympanic available. And rectal is NEVER permitted (along with enemas and most suppositories) d/t risk of bleeding/infection.

On most other units, rectal or oral is preferred by the MDs for accuracy, though fat chance on getting most adults to permit a rectal temp. Axillary is frowned on.

If I was the patient I would refuse a rectal temp. Unless there is no possible way of getting it any other route.. I don't use rectal. I will use axillary on a resident who can't really keep anything in her mouth and we don't have a temporal thermometer.

[kessadawn, BSN, RN]

I work in PICU, our intensivists don't like axillary temps either, and we don't have temporal thermometers as they can be very inaccurate. Our general care floors use them, though. I floated out one might, had a little kid that felt pretty warm, temporal thermometer said normal temp, rectal thermometer said 104! We only do orals and rectals in my PICU.

We also have foley that have a temp probe that we use in critical patients. In very rare cases we will do axillary, such as bleeding risks, prolapsed rectum, and if the child is to young to take a proper oral temp.

[Sun0408, ASN, RN]

We have those in my unit. What I do is swipe it across the forehead down to the ear, then go from behind the earlobe down the neck and then release the button.. It is pretty accurate, if I am not sure I will redo it by run it down the groin area. I have had to do it that way with one pt that kept his room 60 degrees and a fan blowing on him..

[blondy2061h, MSN, RN]

Tympanic.

[psu_213, BSN, RN]

In our ED oral is the first choice. In triage, if they are unable to do oral, they will do temporal. Several of the docs will not 'accept' a temporal or axillary temp, and they will put an order in for an oral or (if unable to do oral) rectal temp. Although I did not get a chance to read it carefully, I saw something at work that said EBP showed the accuracy of temp sites. If I remeber correctly oral and recal were at the the top (assuming no recent PO intake) with temporal and axillary at the bottom of the list.