Which temp is more accurate Oral vs Tympanic??

[SonorityGenius]

Hey everyone,

So I am in midst of an arguement at work between a CNA and a new grad RN over which temp is more accurate Oral or Tympanic.. now I know different variables come into play using both i.e with oral pt may have drank something cold or hot or with tympanic laying on one side on pillow can cause false highs etc etc so lets assume no such variables are in play - which temp would be most accurate?

[Lovely_RN, MSN]

I don't care for temporal thermometers. When one of my kids had RSV when they were an infant the temp I was getting at home was reading about 99 on the temporal thermometer I used to use. Less than half hour after I took that temp she developed respiratory distress and I rushed her to the ER and when the rectal temp was taken it was 103.4! So much for accuracy. It was before I became a nurse and I felt like a horrible parent because if she didn't go into distress I would not have treated that temp.

I think the worst are the temporal artery thermometers. We use this kind http://www.quickmedical.com/exergen/5000.html on my unit and the temps will vary from one side of the forehead to the other. It's not at all unusual to get a temp of 99.4 on the right side of the forehead and then 102 on the other side. I end up wasting my time taking the temp over and over and just going with the number that keeps showing up consistently. I don't trust a single reading from that thermometer.

[tdmaher]

I am in nursing school and we were just discussing this. Our instructor said some practices have done away with using tympanic altogether because of the inaccuracy. So.. I would have to say oral.

[casi, ASN, RN]

I would rather do a pit check rather than a tympanic temp.

I find that you can do three successive temp checks on someone with a tympanic thermometer and get three different numbers.

[Streamline2010]

FYI -- I'm always one degree higher in one ear than the other (even had my doc check out my ears to see if he could see anything -- nope). So either half my brain's running hot, or these things just aren't accurate.

Seems logical to me. People are left or right brain. Circuits on one side would get heavier usage.

On a serious note, I've also been told on nursing school that tympanic is more accurate, but the hospital ALWAYS uses oral temp, and not right after patient has had a hot or cold beverage.

[nerdtonurse?, BSN, RN]

Just one addendum -- when you've got a crazy LOL or LOM who's clawing, biting, kicking, trying to frankly kill anyone that gets into arm's reach, busts out of restraints faster than Houdini -- I'm thankful I've got a 5 second tympanic, cause they'd eat an oral, claw you to death if you tried to take it under the arm, and it doesn't even bear thinking about to get a rectal....

[wooh, BSN, RN]

IMO, it depends more on the thermometer and accurate use of the thermometer than on what kind of thermometer it is. Dying batteries in a thermometer will read lower. For tympanics, it's not just sticking it in the ear. There's pulling the ear to get the tympanic "down in there" that generally people don't do. Temporal (it's been so long since I used one, that I can't remember exactly) but you don't just "run across the forehead" with those. If you have a good thermometer, and use it correctly, all other things being equal, you can get an accurate temp.

[SonorityGenius]

Thank you everyone! I did lean towards Oral as well but the new grad RN thinks she knew everything and kept saying "EBP states tympanic" blah blah

[akulahawkRN, ADN, RN, EMT-P]

Tympanic units are VERY accurate... however they also are extremely sensitive to user technique. You MUST give the sensor an unobstructed "look" at the tympanic membrane because anything else will give a bad read. If there's a local infection, it will also give an error because of the local increase in the metabolic rate in the area. Oral units have their confounding factors. Foley and Rectal temps will have their problems as well.

Use whatever device you have and be cognizant of it's limitations, work within them, and you'll do just fine... generally speaking.

[xtxrn, ASN, RN]

People also don't always use the tympanics correctly.... They just poke them in any old way, and take what they get I've also had nurses, techs, PCTs, etc (office, hospital) take mine with a tympanic, and what they got was an external ear temp Patients either don't know or don't feel they can say if the end is truly in the canal.

[picurn1972, RN]

top them both temporal artery thermometer most accurate, scan the forehead to ear. detects increasing and decreasing temps up to 2 hours faster than either axillary or rectal new data supports this. Rectal is 1 degree warmer than axillary, theyre are variations of normal temps dependent on location taken. Accuracy is dependent on the user in many instances.