Fever...

[katbemeEMT-B]

And most EMTs wouldn't know what a TM looked like if it is staring them in the face, much less how to find it. So, what happens is that the vast majority of the time, you end up taking the temp of the EAC or of a big ear booger instead of the TM.

:roll:

EWWW That's grosssssss! I hate ear boogers. But you have a valid point.

For the most part I thing we go by how their skin feels anyway. If they are really warm we will take a temp only because the hospital will ask if we did. Again, what can we really do for them prehospital but a light sheet and some ice packs to assist in cooling and maybe an IV for hydration.

[Dustdevil]

Again, what can we really do for them prehospital but a light sheet and some ice packs to assist in cooling and maybe an IV for hydration.

There are a great many conditions we diagnose that we cannot do anything for in the field. But we still need to know what is going on with our patient, regardless of the interventions we can offer. Otherwise, we look like complete idiots in our reports and on our charts for not picking up the obvious or significant clues to the patient's condition. A patient can run a significant fever without you noticing by feel. And, conversely, a patient can feel raging hot and have no fever at all. It's just not a reliable indicator. I read a study many years back where they tested nurses abilities to tell a temp by feeling with their hands, and the results were quite dismal.

It's just interesting that EMT schools get all focused on this DCAPBTLS and other pointless acronym madness, looking for obscure, rare signs on every patient, while never even covering the obvious and useful. It's criminal that a school would even mention fever without ever covering the proper way to take it or interpret it. But, then again, most people who teach EMT school don't even know themselves.

[spenac]

On the ambulance we primarily use oral temp. We check temp on just about every patient. We don't treat the temp we treat the patients signs and symptoms. Yes we do try to bring down the temp. But as this is in BLS discussion all you can do is cool them down and keep an eye on the vitals. Be prepared to deal with shock. Don't cool to fast as can cause shivering which is part of the body's heating mechanism and fights your cooling processes.

[katbemeEMT-B]

There are a great many conditions we diagnose that we cannot do anything for in the field. But we still need to know what is going on with our patient, regardless of the interventions we can offer. Otherwise, we look like complete idiots in our reports and on our charts for not picking up the obvious or significant clues to the patient's condition. A patient can run a significant fever without you noticing by feel. And, conversely, a patient can feel raging hot and have no fever at all. It's just not a reliable indicator. I read a study many years back where they tested nurses abilities to tell a temp by feeling with their hands, and the results were quite dismal.

It's just interesting that EMT schools get all focused on this DCAPBTLS and other pointless acronym madness, looking for obscure, rare signs on every patient, while never even covering the obvious and useful. It's criminal that a school would even mention fever without ever covering the proper way to take it or interpret it. But, then again, most people who teach EMT school don't even know themselves.

I agree we need to know what is going on with our patient. I was referring to dealing with a fever above. It is imperative that we know what's going on with the patient. That is why it is just as imperative to get a patients history including previous illness, injury, & surgery; medication; events of the current episode; and all other pertinent medical and non-medical information. You combine this with your vitals, physical and what I like to call a simple neuro exam and you should be able to get an overall picture of your patient. While it seemed I left the bag by the door in my previous post I by no means meant that to feel the patient was the only way to check for fever. It has been my experience that yes, your right, this can be very misleading. More often than not it is because the temp. of the emt/medics hands will determine how warm the patient feels. We use this as an initial tool to assessment before the patient is in the rig and we can access a thermometer. In school we were taught to take axillary temps. but unfortunately on our rig we carry the beloved ear thermometer. We have an oral therm. but it is connected to our BP machine which lately spends more time getting repaired than it does on our rig. I don't mind doing manual BPs but others claim they can't hear anything. Gee, that's why you watch the gauge dummies and visualize the pressure. Anyway Dust, thank you for pointing this out to me.

[ERDoc]

I read a study many years back where they tested nurses abilities to tell a temp by feeling with their hands, and the results were quite dismal.

Yeah, that study (or a similar one) also found that mothers are actually quite accurate. I will look on pubmed and see if I can find it when I have some free time.

[Dustdevil]

Yeah, that study (or a similar one) also found that mothers are actually quite accurate. I will look on pubmed and see if I can find it when I have some free time.

LOL! I remember that, now that you mention it! Mid 90s, I believe.

I don't remember the particulars of the study methods though. Seems like it was just an informal statistic from kids presented to the ER. Mothers use a lot more than just the hand across the head to determine fever in a kid before rushing him to the ER, in most cases. A parent who is in-tune with their kid is at a definite advantage over a healthcare provider who doesn't know the kid. But yeah, I've had more than a few parents rush a kid in whose ONLY symptom was a hot forehead, and they are frequently right.