Advantages and Limitations of Select Temperature Measurement Sites

Oral

Advantages

• Easily accessible—requires no position change
• Comfortable for patient
• Provides accurate surface temperature reading
• Reflects rapid change in core temperature
• Reliable route to measure temperature for intubated patients
Limitations
• Causes delay in measurement if patient recently ingested hot/
cold fluids or foods, chewed gum, or smoked
• Not used with patients who have had oral surgery or facial
trauma or are unable to position in mouth, shaking chills, or
history of seizures
• Not used with infants; small children; or confused, unconscious,
or uncooperative patients
• Risk for body fluid exposure

Tympanic Membrane

Advantages

• Easily accessible site
• Obtained without disturbing, waking, or repositioning patient
• Used for patients with tachypnea without affecting breathing
• Provides accurate core reading because eardrum is close to
hypothalamus; sensitive to core temperature changes
• Very rapid measurement (2 to 5 seconds)
• Unaffected by oral intake of food or fluids or smoking
• Used in newborns to reduce infant handling and heat loss

Limitations

• More variability of measurement than with other core
temperature devices
• Requires removal of hearing aids before measurement
• Requires disposable sensor cover with only one size available
• Readings possibly distorted with otitis media and cerumen
impaction
• Not used with patients who have had surgery of the ear or
tympanic membrane
• Does not accurately measure core temperature changes during
and after exercise
• Affected by ambient temperature devices such as incubators,
radiant warmers, and facial fans
• Anatomy of ear canal makes it difficult to correctly position in
neonates, infants, and children younger than 3 years of age
• Inaccuracies reported because of incorrect positioning of
handheld unit

Rectal

Advantages

• Argued to be reliable when oral temperature cannot be obtained

Limitations

• Lags behind core temperature during rapid temperature changes
• Not used for patients with diarrhea or those who have had rectal
surgery, rectal disorders, bleeding tendencies, or neutropenia
• Requires positioning and is often source of patient
embarrassment and anxiety
• Risk for body fluid exposure
• Requires lubrication
• Not used for routine vital signs in newborns
• Readings influenced by impacted stool

Axilla

Advantages

• Safe and inexpensive
• Used with newborns and unconscious patients

Limitations

• Long measurement time
• Requires continuous positioning
• Measurement lags behind core temperature during rapid
temperature changes
• Not recommended for detecting fever in infants and young
children
• Requires exposure of thorax, which can result in temperature
loss, especially in newborns
• Affected by exposure to the environment, including time it takes
to place thermometer
• Underestimates core temperature

Skin

Advantages

• Inexpensive
• Provides continuous reading
• Safe and noninvasive
• Used for neonates

Limitations

• Measurement lags behind other sites during temperature
changes, especially during hyperthermia
• Impaired adhesion from diaphoresis or sweat
• Affected by environmental temperature
• Cannot be used for patients with allergy to adhesive

Temporal Artery

Advantages

• Easy to access without position change
• Very rapid measurement
• Comfortable with no risk of injury to patient or nurse
• Eliminates need to disrobe or unbundle
• Can be used for premature infants, newborns, and children
• Reflects rapid change in core temperature
• Sensor cover not required

Limitations

• Inaccurate with head covering or hair on forehead
• Affected by skin moisture such as diaphoresis or sweating