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PRACTICAL PROCEDURES KEYWORDS TEMPERATURE ASSESSMENT HYPOTHERMIA HYPERTHERMIA THIS ARTICLE HAS BEEN DOUBLE-BLIND PEER-REVIEWED
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Fig 1. A disposable single-use Fig 2. An electronic digital thermometer Fig 3. Read the display of the Fig 4. Position the thermometer in the Fig 5. Read the display of the electronic Fig 6. Analyse and document results
thermometer single-use thermometer posterior sublingual pouch digital thermometer
PATIENT ASSESSMENT
Ultimately there will be a difference between Digital probes (Fig 2), which may be more REFERENCES
sites but this is not necessarily consistent or responsive to fluctuations in temperature
predictable (Pursell, 2007). Nurses should be within lower ranges. Used with disposable Dougherty, L., Lister, S. (2004) The Royal
PART 2 – MEASURING ORAL TEMPERATURE aware of any influences on accuracy of the covers they are also unlikely to transmit Marsden Hospital Manual of Clinical
method recommended by their organisation infection but they must be cleaned according Nursing Procedures. Oxford: Blackwell.
and should ensure both method and site are to manufacturers’ recommendations. These
Pursell, E. (2007) Commentary on Farnell,
AUTHOR Dan Higgins, RGN, ENB 100, Lister, 2004). The maintenance of body decrease towards this level should prompt consistent and documented to accurately devices are relatively inexpensive.
S. et al (2005) Temperature measurement:
ENB 998, is senior charge nurse in critical temperature is essential and is achieved appropriate reporting, in line with any early record fluctuations.
comparison of non-invasive methods used
care, University Hospital Birmingham. through negative feedback, in that any warning scoring systems. THE PROCEDURE
in adult critical care. Journal of Clinical
variation in temperature produces a Hyperthermia (a temperature above 37.5°C) ORAL TEMPERATURE MEASUREMENT Ensure you have all the equipment
Nursing, 14, 632–639. Journal of Clinical
Body temperature is useful in monitoring physiological response to bring it back to a occurs as a result of a resetting of the The thermometer is placed in the posterior required – disposable gloves and apron, Nursing, 16, 215–219
health and illness as it reflects the ability to set point (around 37°C). The centre for temperature set point caused by the release sublingual pouch on either side of the thermometer and patient documentation.
manage heat loss and gain. Its measurement controlling this is in the hypothalamus of the of pyrogens from certain cells, usually as a mouth. The dwell time is directed by the Obtain informed consent for the procedure. Tortora, G.J., Grabowski, S.R. (1996)
is an essential part of assessment and brain (Tortora and Grabowski, 1996). result of cellular ingestion of bacteria. The specific manufacturer’s recommendations. Check product expiry dates. Principles of Anatomy and Physiology.
monitoring in many clinical environments. Fluctuations in temperature occur naturally most predominant cause of hyperthermia is Recent ingestion of food, high respiratory Wash hands. London: Harper Collins.
as a result of: infection. Other causes may include: rates and smoking may all affect oral Don plastic apron and disposable gloves.
CONTROL OF TEMPERATURE Circadian rhythms; Medication; temperature. The role of oxygen flow in
For more Practical Procedures
Humans are described as homio-thermic, or Age, particularly in babies as their ability to Central nervous system insult; producing cold gas currents has also been For single-use thermometers
subscribers to Nursing Times
having a core temperature that remains thermo-regulate is immature; Systemic inflammatory response investigated as a factor in causing Place the sensor downwards (dot side)
can log on to nursingtimes.net and
constant within a specific range, in spite of Exertion/exercise; syndrome. erroneous data and should be considered if into the posterior sublingual pouch.
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environmental changes (Dougherty and Hormonal balance, for example ovulation. Temperatures above 37.4°C, or a trend of spurious results, or results that are Leave for the recommended time.
Hypothermia (a temperature below 35°C) temperature increase towards and above this incongruent with the patient’s other clinical Remove and read temperature immediately
occurs where the mechanisms to create heat level should prompt appropriate reporting, in assessment data occur. As with all clinical as per the manufacturer’s instructions (Fig 3). as per the manufacturer’s instructions (Fig 5).
PROFESSIONAL RESPONSIBILITIES
production are ineffective. Causes include: line with any early warning scoring systems. assessment data, measured values should Dispose of thermometer. Dispose of thermometer cover, clean
Exposure; be viewed as part of a trend, or fluctuation thermometer as instructed.
This procedure should be undertaken Metabolic derangement; TEMPERATURE MONITORING SITES from baseline values. For digital thermometers
only after approved training, supervised Medication or alcohol; There has been much debate over the Oral thermometers may be: Apply disposable slip to thermometer. After the procedure
Catherine Hollick
practice and competency assessment, Deteriorating physiological function, for accuracy of different sites compared with the Single-use plastic strips (Fig 1) with heat- Place sensor under the patient’s tongue Wash hands.
and carried out in accordance with local example in shock/systemic inflammatory gold standard of temperature measurement, sensitive pads that react (change colour) to into the posterior sublingual pouch (Fig 4). Document result, and any data that may
policies and protocols. response syndrome. the pulmonary artery catheter, which is only heat at certain temperatures. They are cheap, Leave for the recommended time. have influenced readings (Fig 6).
Temperatures below 35°C, or a trend of used in a small group of critically ill patients. easy to use and unlikely to transmit infection; Remove and read temperature immediately Report as necessary.
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