Should all patients have temp checked rectally?

[spenac]

(spin off of fever)

Oh no here I go again. Must stop myself but nope can't do it. In fever discussion it was brought up that the only accurate way to check temp was rectal.

So my questions are:

1. Should all patients have temp checked rectally?

2. If not all, what criteria should be met to do rectal temp?

3. Should rectal temp be done on the ambulance?

4. Does anyones ambulance service do rectal temps?

5. What methods does your ambulance service use for checking temps?

OK let the fighting I mean discussion begin. Round 1. DING

[8151]

BLS Skill perfect for the EMT's

[ERDoc]

As much of a proponent of rectal temps as I am, I don't know if it needs to be done in the field. It isn't going to change your treatment really and there isn't the most privacy. I would never fault any crew for coming in without a temp. Where is trained and where I currently work, no one in the field checks a temp.

[AZCEP]

Using "all" as a qualifier automatically means no.

Some should probably have one done, but not every patient will need it done this way. Unless you are allowed to change the treatment you provide based on the temperature you get, it does not have to be rectal.

[paramedicmike]

I worked in a place that carried tympanic thermometers. I won't say it never affected our treatments. I will say that it saved a few of my less than stellar coworkers from giving lasix to a pneumonia patient. Of course, the prodding of their partner(s) helped with that, too.

-be safe

[spenac]

As much of a proponent of rectal temps as I am, I don't know if it needs to be done in the field. It isn't going to change your treatment really and there isn't the most privacy. I would never fault any crew for coming in without a temp. Where is trained and where I currently work, no one in the field checks a temp.

Just to keep stirring the pot why is privacy an issue? Just cover the windows and lock the doors, just as private if not more so than the curtains at so many ER's.

We check oral temp but why not get more accurate temp especially with 90 mile transport?

Just asking try not to hit me to hard just yet.

[Michael]

A nurse goes into a bank to cash her paycheck. At the teller's window she reaches in her pocketbook, takes out a rectal thermometer, and tries to endorse the check with it. Then she pauses, looks up at the teller, and, realizing her mistake, exclaims, "Well that's great! Just great. Some ******'s got my pen."

[katbemeEMT-B]

I wouldn't say for all patients. Let's be serious, when you get some patients in your rig and it takes you longer to find the hole than it does to get to the ED you aren't going to get into the habit of taking their temps. Also, we don't do temps on all patients. I think this would definitely be a positive for ped patients. When they are screaming you can't get an oral. This also increases the tympanic and axillary temp. Rectal is the best way to go with them. WARNING!!! Duck and cover when taking rectal temp on infant 'cause it's gonna blow. :pottytrain2:

So in answer to the question: Nope not all patients should have a rectal temp.

[AnthonyM83]

We don't carry thermometers in the field. They'd be nice to have available, though, for some cases...such as fevers to know urgency of transport (febrile seizure at 103.5 versus 106.7 and rising)

[spenac]

We don't carry thermometers in the field. They'd be nice to have available, though, for some cases...such as fevers to know urgency of transport (febrile seizure at 103.5 versus 106.7 and rising)

We used to carry ear thermometer with $6 oral as back up. We now keep $300 oral with optional rectal probe. The cheap ones work for most cases but if get a noisy kid takes to long. The high dollar one quick and to the point.