1. Presentation titleSUB TITLE HERE
How to
Measure
Temperature
Vital Signs in the
Ambulatory Setting:
An Evidence-Based Approach
Cecelia L. Crawford
RN, MSN

2. Temperature Techniques & Methods:
An Overview
•Temperatures can be
different depending on
 Type of Thermometer
Glass or Chemical Dots
Electronic or Tympanic
 Body Site
Oral, Axillary, Rectal, Ear

3. Type of Thermometer - Glass
•Once viewed as the “Gold Standard”
•Must be left in for several minutes
 Up to 7 minutes for an accurate temperature!
•Now associated with adverse events
 Rectal or oral trauma
 Breakable
 Mercury exposure

4. Type of Thermometer – Chemical Dots
•Single use
•Disposable & inexpensive
•Axillary, Rectal, Oral
•Can be difficult to read
•Long measurement time needed
 Up to 7 minutes for an accurate temperature!

5. Axillary Temperature
•Safe & inexpensive
•Often inaccurate because:
 Long measurement time needed
 Patient must be still
 Patient must be positioned or held
•Not recommended for young
children
•Must document as an axillary
temp and NOT an oral temp

6. Rectal Temperature
•Thought to be as accurate as an oral temp
•Needs lubrication
•Long measurement time needed
•May cause rectal trauma & cannot be used with:
 Newborns
 Diarrhea
 Rectal surgery or bleeding
•Patient may be embarrassed
•Patient must be positioned or held
•Must document as a rectal temp

7. Oral Temperature
•Comfortable & easy, no positioning needed
•Accurate temps when proper technique used
 Must place thermometer tip in left or right mouth pocket
under tongue
 IS influenced by hot & cold fluids
 NOT influenced by breathing

8. Oral Temperature
•Long measurement time
•Should not be used with:
 Confused or uncooperative
patients
 Infants & small children
 Oral surgery or oral trauma
 History of seizures or chills

9. Temperature Technology
Automated Temperature Machines
 Electronic and infrared thermometers
 Convenient
 May save time & labor

10. Ear (Tympanic) Temperatures
•Easy site to use with accurate temps
•Rapid measurement – 2 to 5 seconds!
•Uses disposable, single use probes
•No interference with breathing
•Little patient positioning needed
•Not effected by food, drink, or smoking
•Can be used with all age groups & most patients
 Newborns (no heat loss), infants & small children
 Useful with confused & uncooperative patients

11. Ear (Tympanic) Temperatures
•Can be affected by heat & cold:
 Heating & cooling measures
Hot packs, ice packs, heating blankets
 Extreme outside and inside temperatures
Air conditioners, overheated rooms
Very hot or very cold days
 Bathing or swimming
 May need to wait 20 minutes for accurate temp

12. Ear (Tympanic) Temperatures
•Can also be affected by:
 Impacted ear wax & ear
infections
 Whether an ear tug is used
•Should NOT be used if
patient had ear surgery

13. Ear (Tympanic) Temperatures
•What Patients Think About Ear Temperatures
 Parents of pediatric patients like them!
 Fast, easy, clean, and safe
 Pediatric patients react better!
 Faster measurement
 Can stay in parent’s lap or arms
 No holding or restraining
 No positioning

14. Tympanic Temperature Procedure
1. Wash hands & put on gloves if appropriate
2. Assist patient into a comfortable position
• Head turned to side, away from HCW
• Pediatric patients can be in parent’s arms or lap

15. Tympanic Temperature Procedure
3. Remove thermometer
from handheld unit
• Slide disposable probe
cover over probe tip until
locked in place
• Do not touch lens cover
• Do not apply pressure to
ejection button
http://www.lane.k12.or.us/CSD/CAM/level1/ASSESS

16. Tympanic Temperature Procedure
4. Use correct ear to
measure temperature
• If holding
thermometer in right
hand, use right ear
• If holding
thermometer in left
hand, use left ear
http://www.lane.k12.or.us/CSD/CAM/level1/ASSESS

17. Tympanic Temperature Procedure
5. Insert covered thermometer probe into
ear canal and position properly
• Children 1 year & older/Adults:
Gently pull top of ear back, up, &
out
• Children less than 1 year: Gently
pull top of ear straight back
• Point tip towards nose
• Less than 2 yrs: point tip between
eyebrows & sideburns
• Snugly fit probe tip in ear canal and
do not move

18. Tympanic Temperature Procedure
6. Depress scan button on handheld unit
7. Leave probe in place until a “beep” is heard
• Temperature will appear on digital display screen
8. Carefully remove probe from ear canal
9. Push ejection button on handheld unit to
remove probe cover
• Place used probe cover in trash – DO NOT REUSE!

19. Tympanic Temperature Procedure
10. To repeat a temperature measurement:
• Use a new probe cover
• Wait 2-3 minutes if using the same ear
• May use the opposite ear with new probe cover
11. When temperature measurement is done:
• Return handheld unit to thermometer base
• Tell patient the temperature reading
• Assist patient to comfortable position
• Remove gloves & wash hands

20. Tympanic Temperature Procedure
• Inform RN or MD if:
 Very low or very high temperature
 Normal temp: between 97o to 100o F
 Ear wax is seen in ear or on probe cover
 Unable to get a temperature reading due to:
 Uncooperative patient
 Confused patient
 Parent or patient refuses
 Machine malfunction

21. Tympanic Temperature Procedure
12. Document the Results
 Flowsheet, clinic record, or clinic chart
13. Communicate the Results
 RN
 MD

22. Temperature Measurement in the Clinic
• YOU can make the
difference:
 Welcoming presence
 Decrease any anxieties &
fears
 Reassure patients & family
 Accurate vital signs