Locations of measurement
The temperature is usually recorded at one of four sites: oral, axillary, rectal and tympanic. Nowadays hospitals usually use modern digital devices for recording temperatures on the wards. These often record tympanic temperatures and come with disposable caps. Occasionally, some newer ones record cutaneous forehead temperatures using rather futuristic-looking devices. A lot of senior doctors are very much against these, as they feel that the readings are not always reliable. The tympanic ones are usually very easy to use - just place a new disposable cap on the tip, turn the device on, and insert it into the ear. The machines usually bleep when they have have a reading, a process that takes a couple of seconds.
Normal temperature readings
oral: 36–37oC axillary: 36.4 oC rectal: 37.6 oC Temperature recording
1. Glass 'mercury filled' thermometers are now rarely used as these have been largely replaced by digital thermometers. Ensure that it has been appropriately cleaned. Place a plastic protective sheath over the thermometer or if not available clean with an alcohol-soaked swab.
2. Introduce yourself to the patient, check their identity, explain what you are going to do, obtain consent, and wash your hands. It is probably best to wear gloves for the rectal techniques...
3. For oral temperature measurements, ideally, it should be at least 10 minutes since the patient last drank any fluids/smoked a cigarette. This does not apply to other methods of recording the temperature
4. For the old style mercury thermometers, shake the mercury in the glass thermometer down to below 35 o. Again, this is not required for new digital thermometers.
5. Place the thermometer in the desired orifice (in mouth of patient sublingually, on one side of midline frenulum / in the ear canal / in the rectum (with lubrication) / in the axillary area).
6. For oral recordings, ensure that the patient's lips are fully closed around the thermometer to hold it securely in place.
7. Whilst mercury thermometers used to require being held in place for 3-4 minutes, digital ones usually produce a result in seconds. Remove the thermometer and (for mercury ones) hold horizontally, turning slowly until a mercury strip is seen running down the side of the thermometer. Digital ones should record the temperature immediately.
8. Record this on the observations chart.
9. Clean the thermometer / dispose if the plastic cap.
10. Thank the patient, and wash your hands.
