Should all patients have temp checked rectally?

[FireMedic65]

You really should care and you cannot properly actively rewarm a patient properly without a constant core measurement. If you are going to go as invasive as internal cavity lavage, then you ABSOLUTELY need a thermometer probe up their rear. Without it, how are you going to monitor for after warming drop, or worse hyperthermia? How will you (other than the obvious symptom of death) identify and stay ahead of such complications as rewarming shock? No we do not need to shove a thermometer up every pts. ass we come into contact with, but some do require it, hypothermics especially.....................

i should have been more specific and explained what I meant better. i was merely trying to get the point across that rectal temps are all but useless in the pre-hospital setting

[Dustdevil]

i should have been more specific and explained what I meant better. i was merely trying to get the point across that rectal temps are all but useless in the pre-hospital setting

And again you fail.

As for this whole BGL on every patient thing, it's just stupid! These are monkey protocols without any sound medical foundation. If your medical control has you doing this, you can pretty well assume they don't trust you and your assessment skills. Not that I can really blame them. I can give you a lot more justification for doing a pregnancy test on every female patient than you can ever give for doing a BGL on all patients.

Man... the suck-arse state of some systems is just mind boggling. And the scary part is that their medics don't even realise it. :?

[spenac]

And again you fail.

As for this whole BGL on every patient thing, it's just stupid! These are monkey protocols without any sound medical foundation. If your medical control has you doing this, you can pretty well assume they don't trust you and your assessment skills. Not that I can really blame them. I can give you a lot more justification for doing a pregnancy test on every female patient than you can ever give for doing a BGL on all patients.

Man... the suck-arse state of some systems is just mind boggling. And the scary part is that their medics don't even realise it. :?

ROFL. You crack me up dust. You know I implement all your suggestions into the protocols, now we'll hand all females a stick and say pee on this. :wink: Might even have the males do it in case had a botched sex change. :? With all the requirements patients are bound to quit calling.

The only reason to do BGL every patient is so they can't sleep on the way to the hospital. Thats what I like about our protocols lots of room to think on our own, other than ABC's pretty much we can adjust to each patients needs.

[paraloco]

Ok, those of you with more hospital experience than myself, how prevalent is rectal temperature taking in the hospital environment (not just pediatrics)? Where I am, it used to be done on unconscious patients, but if they have a foley they just use the criticore temp instead. I'm old enough to remember when it was the norm, especially for kids. Looking back at it now, I can see one reason why. Those old glass thermometers had mercury in them. What better way to ensure that a kid didn't bite down on it than to stick it up his butt, however demoralizing it might be. It was kind of a Kafkaesque aspect of being a kid. Go to the doctor. No matter your complaint, nurse in white stockings and a funny hat comes in, shaking down a thermometer. " uh, I feel much better now. Really."

[speedygodzilla]

Ok, those of you with more hospital experience than myself, how prevalent is rectal temperature taking in the hospital environment (not just pediatrics)? Where I am, it used to be done on unconscious patients, but if they have a foley they just use the criticore temp instead. I'm old enough to remember when it was the norm, especially for kids. Looking back at it now, I can see one reason why. Those old glass thermometers had mercury in them. What better way to ensure that a kid didn't bite down on it than to stick it up his butt, however demoralizing it might be. It was kind of a Kafkaesque aspect of being a kid. Go to the doctor. No matter your complaint, nurse in white stockings and a funny hat comes in, shaking down a thermometer. " uh, I feel much better now. Really."

I work in the hospital ER for 2 months and have never seen or had to get a rectal temp on any patients other than pediatrics. I don't think that it is needed. I really don't see why we don't have EMS get at least get the temporal temp in the field. I know that every patient get some kind of Temp in the hospital ER. Even if it won't effect the treatment it is good to get for a baseline vital (temporal temp, not rectal) in the field.

As for the BGL, we don't get those on patients in the ER unless they have a history, or if it is suspected. Many of the labs we do, check this anyways for every other patient. If the labs come up with an odd number than we check it with the meter, and always capillary even if they have an IV.

In the ER we check every female of age with abd pain for pernancy. This is not as easily done in the field, and as it maybe nice in some cases, it is not needed in the field.

Personally I much rather have EMS check my BGL, than check a rectal temp on me.

[Ridryder 911]

[

I work in the hospital ER for 2 months and have never seen or had to get a rectal temp on any patients other than pediatrics. I don't think that it is needed. I really don't see why we don't have EMS get at least get the temporal temp in the field. I know that every patient get some kind of Temp in the hospital ER. Even if it won't effect the treatment it is good to get for a baseline vital (temporal temp, not rectal) in the field.

As for the BGL, we don't get those on patients in the ER unless they have a history, or if it is suspected. Many of the labs we do, check this anyways for every other patient. If the labs come up with an odd number than we check it with the meter, and always capillary even if they have an IV.

In the ER we check every female of age with abd pain for pregnancy. This is not as easily done in the field, and as it maybe nice in some cases, it is not needed in the field.

Personally I much rather have EMS check my BGL, than check a rectal temp on me.

Let me know what hospital you work at & I will avoid it. Never seen a patient with a fever? Tympanic (not temporal) temps are considered inaccurate and worthless, especially in those that are febrile.

All patients with possible sepsis, hyper/hypothermia should have baseline rectal core temps. They are called core temps for a reason.

I suggest your ER and clinical manager do some investigation on core temps and policies. Emergency Nurses Association as well ACEP has some recommendations. There is some great literature and studies out there.

R/r 911

[spenac]

Dang it not again I hate it but I agree with R/r. There are many times you need a more accurate temp for definitive care. I can see only doing it on the rare times in the ambulance, but come on in the ER relying on inaccurate methods, just scary. Serious patients need to be completly evaluated so they can be properly treated. I hope you have just missed the more detailed exams otherwise I feel for your hospitals patients.

[Jess]

Hate to break it to you all, but every hospital i've ever been at (and I've lived all over the US) I've only seen them take temps orally unless its a baby or small child then its rectally. Actually the ear thermometers are getting more and more common for ALL ages. Its scary, very scary only because of the inaccuracy. But i do agree with you R/R Sorry i don't have much to contribute to this topic but just thought i would share my observations. take care all

[zippyRN]

Let me know what hospital you work at & I will avoid it. Never seen a patient with a fever? Tympanic (not temporal) temps are considered inaccurate and worthless, especially in those that are febrile.

All patients with possible sepsis, hyper/hypothermia should have baseline rectal core temps. They are called core temps for a reason.

I suggest your ER and clinical manager do some investigation on core temps and policies. Emergency Nurses Association as well ACEP has some recommendations. There is some great literature and studies out there.

R/r 911

Rid you're the muppet here

a temporal temp is not a tympanic temp qand it falls down from there

what is the evidence base you fail to cite and the 'power' of that evidence

the temporal artery is pretty close to the surface over the temples - there are thermometers available which take advantage of this to provide a quick, simplenone invasive but more accurate than tympanic , less prone to PEBKAC than oral temps

we use the exergen (www.exergen.com) in all settings in the trust I work for although Critical Care areas do have invasive temp measurement available ...

there are also other things to consider when advocating invasive tests as a baseline ...

[Dustdevil]

Rid you're the muppet here

a temporal temp is not a tympanic temp qand it falls down from there

Zip, are you sure you're from England? Because you're having some pretty serious problems understanding some pretty basic English.

Not only was Rid not talking about temporals, he went out of his way to make that point clear. :roll: