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.
When I was working in a peds hospital, we did oral if the child was able, otherwise axillary. Our thermometers had three settings: oral, pediatric axillary, or adult axillary (which we used for adult-sized kids) -- these would adjust for the differences between the sites. With axillary temps, you want to make sure the metal part of the probe is completely within the armpit, and that the child keeps their arm closed on it -- with assistance, if necessary. On the few occasions when I got both types of temps for the same patient, the numbers seemed to agree pretty well, and when a child had a tactile fever, we pretty much always found a fever with the axillary temp too.
We only did rectal temps with a special order -- for example, we had one chronically ill child whose parents insisted on rectal temps (child could not do oral and parents didn't trust axillary). We also did rectal temps on kids who had circulatory issues such that an axillary temp would not be accurate and who were too young for oral temps.
We only have oral/axillary and tympanic thermometers on our floor. Our tympanic thermometers are very limited - something like 2 or 3 for the whole floor - so if you're stuck with an oral/axillary thermometer because the tympanics are taken, you must make do with it. We try to do oral temps but if they're uncooperative (i.e. confused), then axillary it is.
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?
No I just noticed that I get weird readings if I do not actually put it on the neck below the ear and hold it there for a second and release the button while it is still in full contact with the skin.
Specializes in Pulmonary, Lung Transplant, Med/Surg.
Thanks everyone! The other thing I should have mentioned is that we get alot of patients on bipap, so oral is out and so is temporal d/t the device being over the patient's head.
Specializes in Emergency Dept. Trauma. Pediatrics.
I do oral with that little red ended thermometer :|
KIDDING!
One health system hear primarily uses the forehead thermometer, I don't think they are very good at all, the ear ones either. Another system primarily does oral with an option for underarm on the device.
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trebugRN
15 Posts
I work in peds and we almost always do axillary temps.