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Should schools "profile" all students to identify those who may become violent?
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Quick reference medical handouts used by Pediatric offices


Taking Your Child's Temperature


Taking Your Child

Taking Your Child's Temperature


What are the different ways to take a child's temperature?

Click on the method to learn more

What is the normal temperature?
The normal temperature varies depending on the method used.

Measurement method

Normal temperature range

Rectum

36.6°C to 38°C (97.9°F to 100.4°F)

Mouth

35.5°C to 37.5°C (95.9°F to 99.5°F)

Armpit

34.7°C to 37.3°C (94.5°F to 99.1°F)

Ear

35.8°C to 38°C (96.4°F to 100.4°F)

Fever Strips -not accurate-

Body temperature is increased somewhat by: Drinking Hot Beverages, Taking a Bath, Physical Exertion, and being Dressed Too Warmly

Which method should be used for taking a child's temperature?
The method used depends on the age of the child

Age

Recommended technique

Birth* to 2 years

First choice:    Rectum (for an exact reading)
Second choice:    Armpit (to check for fever)

Between 2 and 5 years

First choice:    Rectum
Second choice:    Ear
Third choice:    Armpit

Older than 5 years

First choice:    Mouth
Second choice:    Ear
Third choice:    Armpit

*remember, any temperature in a child less than three months warrants a call to the pediatrician


Thermometer for Rectal, Oral, and Axillary Methods

We do not recommend using mercury thermometers. Accidental exposure to this substance can occur if the thermometer breaks, as well as possible injury from broken glass. In addition, mercury thermometers require a longer wait time and are harder to read than the digital types, which only about a minute to obtain a reading, and indicate when they are  done. 

Methods of Temperature Taking
Rectal

Taking the temperature rectally has traditionally been considered the best method for temperature measurement but many recent studies have revealed some of its limitations For example, rectal temperatures are slow to change in relation to changing body temperature, and they have been shown to stay elevated well after the child's body  temperature has begun to fall, and vice versa. Rectal readings are also affected by the presence of stool.  Without proper sterilization techniques, taking the temperature rectally can  spread contaminants that are commonly found in stool and intestinal perforation has been reported. 

Most parents are uncomfortable with this method of temperature assessment, and the majority of children resent it.

How to take a rectal temperature

  • Clean the thermometer with cool, soapy water and rinse.

  • Cover the silver tip with petroleum jelly (such as Vaseline).

  • Place your baby on his back with his knees bent.

  • Gently insert the thermometer in the rectum, about 2.5 cm (1 inch), while holding it with your fingers.

  • After about 1 minute, you will hear the "beep." Remove the digital thermometer and read the temperature.

  • Clean the thermometer.

  • Do not use an oral thermometer to take the temperature in the rectum; taking the temperature rectally requires a thermometer specially-designed for taking temperature in the rectum (it is thicker and less breakable).  The bulb of a rectal thermometer is also more rounded. 

Axillary

While axillary (under the arm) temperature is extremely easy to measure (compared with oral or rectal measurements), it has been found to be a poor indicator of body temperature since it is largely influenced by environmental factors (room temperature, child's hydration, etc.) Despite its low sensitivity in detecting fever, axillary temperature is recommended by the American Academy of Pediatrics as a screening test for fever in neonates because it is easy to do and risk free.  If your child is under 2 years of age, and you find a fever when taking the temperature under the arm, confirm it by taking a rectal temperature.

  • Use a rectal or oral thermometer.
  • Clean the thermometer with cool, soapy water and rinse.
  • Place the tip of the thermometer in the centre of the armpit.
  • Make sure your child’s arm is tucked snugly against her body.
  • Leave the thermometer in place for about 1 minute, until you hear the "beep."
  • Remove the digital thermometer and read the temperature.
  • Clean the thermometer.
Oral

The mouth is easily accessible and reflects the temperature of the arteries of the tongue.. However, oral temperature is easily influenced by the recent ingestion of food or drink and mouth breathing. Taking the temperature this way relies on the mouth remaining sealed, with the tongue depressed for 3 to 4 min, which is a difficult task for children. This method of temperature measurement cannot be used in young children, or in unconscious or uncooperative patients. Pacifier thermometers are available but have yet to be evaluated Generally, it has been suggested that the accuracy of taking the temperature "under the tongue" lies somewhere between that of axillary and rectal methods. It appears that accuracy may increase with the age of a child, primarily due to compliance and the ability to use proper technique. This method may not be practical if the child is coughing or breathing rapidly through their mouth.

  • Clean the thermometer with cool, soapy water and rinse.
  • Carefully place the tip of the thermometer under your child’s tongue.
  • With your child’s mouth closed, leave the thermometer in place for about 1 minute, until you hear the “beep”.
  • Remove the digital thermometer and read the temperature.
  • Clean the thermometer.

 

Ear

The first devices used to measure temperature this way did so by being in direct contact with the ear drum itself. This method was superior even to rectal temperatures, but having an instrument in direct contact with the ear drum is not practical for everyday use. 

Instead of being in direct contact with the ear drum, today’s ear thermometers measure the thermal radiation coming from the ear drum and the ear canal. Since the ear drum's blood supply is very similar in temperature and location to the blood bathing the brain, this method is an ideal location from which to get an estimation of body temperature.  Crying, ear wax, and even an ear infection have not been shown to change these readings significantly.

  • Use a clean probe tip each time, and follow the manufacturer’s instructions carefully.
  • Gently tug on the ear, pulling it back. This will help straighten the ear canal, and make a clear path inside the ear to the ear drum.
  • Gently insert the thermometer until the ear canal is fully sealed off.
  • Squeeze and hold down the button for one second.
  • Remove the digital thermometer and read the temperature.

posted 3 August 2003

 

 

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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