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Morning all,

We currently do not use tympanics at all in our ED (and I believe not in the
entire hospital). In kids who can hold it PO, generally over three and not
too cranky, then PO is fine. If not, rectal. The only exceptions are kids
who have no history of fever and whos reason for ED visit is not likely to
warrent investigation (i.e. 1 yo who got his thumb caught in the car door 30
minutes PTA) or in whom it wold not be wise to risk trauma to the rectal
mucosa (onco and/or neutropenic kids). In these cases, axillary are
acceptable.

Steven Taylor, RN, CEN
Emergency Department
Children's Hospital of Philadelphia


----- Original Message -----
From: "Charles J. Graham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, December 27, 1999 10:26 PM
Subject: How do you take temperatures?


> We have used tympanic thermometers in our peds ED for the past several
> years, but the medical staff here has become very frustrated with them as
> we've had numerous patients with very spurious readings.  I had a baby
with
> sickle cell (8 mo old) who had a tympanic temp of 37.1 C, we asked for a
> rectal temp because he felt hot and his rectal temp was 39 C.  We've had
> several, several such cases.  Our biomed dept has repeatedly calibrated
the
> tympanic thermometers, etc but to no avail.
>
> Because of our frustration, we're reconsidering our method of taking
> temperatures in our pediatric ED.  I was wondering what methods were being
> used in other pediatric EDs.  Do you check tympanics, rectals, etc.?  How
> old before using an oral temp?
>
> Thanks,
> James Graham MD
> Associate Medical Director, Peds ED
> Arkansas Children's Hospital, Little Rock
>
> For more information, send mail to [log in to unmask] with the
message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>   http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html