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In the Intensive Care Unit, nasopharygeal temperature measurements and rectal temperature measurements showed significant positive correlations.

Intermittent rectal probes are replaceable by infrared tympanic thermometry for intubated patients.

Temperature measurement in an intensive care environment requires accurate estimation of core temperature via reliable equipment. Intermittent rectal probes were routinely used to measure core temperature in all extubated patients admitted to the Intensive Care Unit (ICU) which was the setting for this project. The nursing and medical staff identified various problems associated with this practice and a quality improvement project was implemented to compare temperatures recorded using three different routes: rectal, infrared tympanic and nasopharyngeal. Forty-nine patients were included in the study.

Nasopharyngeal temperature measurements were recorded for all intubated patients and rectal temperature measurements were recorded for all extubated patients. During data collection, infrared tympanic temperature measurements were recorded at the same time as all other temperature measurements. The main comparison was between the rectal route and the infrared tympanic route because of the problems with the rectal probes that had been identified by staff. The results indicated statistically significant correlations between temperatures measured at the different sites. These results confirmed previous literature and the ICU involved in this study replaced rectal temperature measurement via intermittent probe insertion with infrared tympanic thermometry for the measurement of core temperature in extubated patients.

There is a good correlation between axillary temperature and oral or rectal temperature recorded by the conventional mercury in glass thermometer.

Derived equation could be used to calculate rectal or oral temperature from axillary temperature.

The placement time of the thermometer should be 3 minutes, 4 minutes and 6 minutes for rectal, oral and axillary temperature recordings respectively.

Axillary site is commonly used for temperature recording in children as it is safe and convenient. However, conflict remains regarding its accuracy and there is no universally accepted equation to predict the core temperature from axillary temperature(1,2). Few studies done in this regard have used improper methodology like use of electronic or uncalibrated thermometers and unsatisfactory data analysis(1). The thermometer placement time required to accurately reflect the stabilized body temperature is also unclear and varies between seconds to 15 minute in various studies(2-6). The present study was done to compare the axillary temperature with rectal or oral temperature in children and to find out the optimum placement time at these sites for conventional mercury in glass thermometer.

Axillary temperature was an acceptable and more comfortable substitute for oral temperature in children.

The ideal technique for measuring temperature should be rapid, painless, reproducible and accurately reflect the core temperature. While axillary temperature is commonly used because of convenience and safety, there are conflicting reports about its accuracy. To determine whether axillary temperature can act as a surrogate for oral/rectal temperatures, a prospective comparative study was conducted. The axillary and rectal temperatures (Group 1: infants < 1 year age) and axillary and oral temperatures (Group 2: children 6–14 years age) were compared using mercury-in-glass, thermometers. Various tests of agreement were applied to the data obtained. Rectal and axillary temperatures for infants agreed well; the mean difference (95% limits of agreement) between the two being 0.6°C (−0.3°C, 1.4°C). Similarly, the mean difference (95% limits of agreement) between oral and axillary measurements for children aged 6–14 years was observed to be 0.6°C (−0.4°C, 1.4°C). Axillary temperature appears to be an acceptable alternative to rectal/oral temperature measurements in children.