Methods of Temperature Measurement: Oral, Temporal, and Tympanic (Nursing)

00:00 Now, let's look at the skill how to take an oral temperature. It's really important to remember when we're talking about the oral route to ask your patient "Have you had anything to eat or drink in the last 15 minutes?" This also includes if your patient smokes as well, so we want to screen our patient. First, we're going to perform our hand hygiene and don our gloves. Then we want to put a new clean probe cover over the thermometer and turn this on. Now, we want to carefully place that tip of the thermometer underneath the client's tongue and have the patients close their mouth and hold that thermometer in place underneath the patient's tongue. Now, we're going to wait the recommended time for the brain to the thermometer and then remove that once it beeps. Now, note that temperature measurement and evaluate for accuracy. Now we can discard the used probe and clean the thermometer per the facility's protocol. Now, with an oral temperature like you see in this image, many times there's a button here that we can push to eject the probe. Now remove your gloves, perform your hand hygiene, and of course document the procedure and the results of the temperature including the route such as oral in the electronic health record.

01:19 Welcome to how to take an oral temperature. I've got my friend, Brandon, here today and we're going to walk you through this step. Now of course, before you take an oral temperature, the first thing you want to remember especially with this route is that we check and ask Brandon "Have you had anything to eat or drink in about the last 15 minutes?" "No." "Okay, great." And also, if the patient has a current smoking history or a past medical history of smoking, we want to check that as well. So now we can go ahead and perform our hand hygiene and don our gloves. So when we're talking about taking oral temperatures, there are different devices that you may use. You guys are really probably pretty familiar with the ones that are just one device, one piece of equipment that goes under your tongue.

02:17 We're going to use a piece of equipment today that's really commonly seen in the hospital.

02:24 Okay, so again, every piece of equipment's a little bit different but this is something typical that you may use. So with this, when I pull out the probe itself, it will go ahead and turn on my device. Then, this have this really handy. Thermometer cover's already here on the back of my device. So once I've got this on, my probe cover and again make sure you change this out for each new patient and then a thermometer is on I'm going to let Brandon know that "carefully if you would place this under the tip of your tongue and make sure you hold down on to it until it beeps." "Okay. So we can go ahead and put this under your tongue, you got that. Perfect." In some patients, you may need to support it or support that for them and then we're just going to wait until it beeps and every time is a little bit different.

03:15 And it says Brandon is at about 98. Now once I do this, I'm going to note the temperature measure and evaluate for accuracy. Now, we can go ahead and discard the probe cover.

03:25 So these are really neat because they have this little blue buttons and this is going to be our ejector for our probe cover. And I'm going to just kick that in the trash and then we're going to clean this per our recommended facility's policy. Now, once I've done this, I can go ahead remove my gloves, we're going to perform our hand hygiene, and of course we're going to document our procedure. Now, it's really important when we document our temperature we also include the route taken in the electronic medical record. Thanks for watching. So let's look at how we take a temporal or a forehead temperature. This is widely used in your healthcare facilities. Now, when we start, we want to perform our hand hygiene. Also note the type of thermometer you're going to use because sometimes this require a probe cover or a cleaning after each use, so make sure you follow your agency's equipment and your facility policy. Now, we can turn on that thermometer by following the manufacturer's instructions where with this type of device it's going to start in the center of the forehead, keep the button depressed while sweeping across with the thermometer across the forehead and along the hairline of the patient, as you see here in this image.

04:44 So now we can note the temperature measurement and clean the thermometer per the facility's protocol, perform our hand hygiene, and document those results. It's also important to remember that we document the route taken in the electronic health record.

05:00 Let's take a look of how we take a temporal temperature or otherwise known as a forehead temperature. So before we get started of course, we're going to perform our hand hygiene.

05:17 So I would also like to take a moment to let you know this equipment's going to vary greatly among facilities so make sure you check your thermometer in the equipment and the manufacturer's guidelines before use. Now, some of these thermometers may require a probe cover so you may want to check that as well and also it may require a cleaning after each use especially between patients. So now we can go ahead and turn on our thermometer by following the manufacturer's instructions. So I'm going to use this just to demo on how the process is to take this type of temperature. So here, I'm going to have Brandon turn his head for a little bit for me. We're going to store and depress the button. It's important to keep the button depressed the whole time you're taking the temperature. So I'm going to start in the middle of his forehead, then we're going to sweep this while keeping that button depressed along the hairline and then once we do that, we've taken our temperature. Now just know some equipment requires you to start in the center just like we did here, sweep across the hairline and even touch behind the ears. So again, please make sure you check your manufacturer's equipment. Now once we've done this, we're going to note our temperature. Then after we've done that, we want to make sure we clean the thermometer per our facility's protocol, perform our hand hygiene, and of course document the results of the temperature in the electronic health record. Now again, don't forget to include the route taken. Let's talk about how we take a tympanic temperature from the patient's ear.

06:58 We're going to perform our hand hygiene, place a probe filter on the thermometer, and then turn on device according to the manufacturer's instructions. Now, here is where the variation comes from the patient population. So if we're talking about an adult or a child older than 3 years of age, we're going to pull the pinna of the ear up and back. Now, if the child is less than 3 years of age, we're going to gently pull the pinna of the ear down and back and these are to straighten the ear canal and get a more accurate temperature.

07:33 Now, we're going to insert the device inside the ear and make sure the client is not completely uncomfortable here and see if it's positioned correctly, it should not cause any pain. Now, press the button on the device to take the temperature and then note the temperature reading and remove the device. And make sure you document those results and the route in the facility's record. Let's take a look of how we take a temperature via the tympanic route or otherwise known as in the patient's ear. Before we get started, we're going to perform our hand hygiene. So just note with this route that many times we'll have a probe filter that goes on the thermometer, so this is great because it helps reduce infection. So let me go ahead and take my thermometer now and place my probe cover. So it's really nice because these are disposable and one-time use. Keyword, one-time use. So, this will fit down into our sleeve here of disposable covers and it snaps on really snugly on our thermometer for use. Then we're going to go ahead and turn on our device according to our manufacturer's directions. Just know again that each device is going to vary among facilities so make sure you check your equipment first. Now, here is something to really note when you're talking about a tympanic temperature route. Now, we have got this straight in the ear canal for the best accurate reading. Now with adults, we're going to pull the pinna of the ear up and back for adult or children about older than 3 years of age. Now, if a child is about less than 12 months old or so, we're going to gently pull the pinna of the ear down and back to straighten that canal. Now, once we have done that, we can insert the device to the ear and then make sure it's comfortable for the client.

09:30 So I'm going to do this now for Brandon. So now I'm going to go ahead with Brandon since he is an adult, of course, we're going to take the pinna and pull it up and back. So now I'm going to go ahead and insert the device. "Now Brandon is that comfortable for you?" "Yes." "No pain, correct?" "No pain." "Okay great." So I'm going to depress the button and take my temperature. Then once I have done that, then I'm going to make sure I note the temperature reading and remove the device. Now, because I've got a probe here, I can go ahead and dispose of that then we're going to clean the thermometer per the facility's protocol. We're going to perform our hand hygiene and document the results of the temperature in the electronic health record and make sure that you document the route that you used.