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A warming trend
You're feeling a little ill and are wondering if you might be feverish. Laying a hand on your forehead to check -- while a popular traditional method -- isn't exactly a precise guage of temperature. That's why every household should have some type of medical thermometer. It's the accurate way to detect a dangerous fever (or dramatic lowering of body temperature, but you probably don't need a thermometer for that). A variety of options are available, including mercury-in-glass thermometers, electronic digitals, skin strips, and tympanic membrane temperature devices.
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Measuring Temperature Effectively
Fevers are often an indication of underlying illness. They can be particularly difficult to detect in children, though they are often the only sign of illness. You may take oral, rectal, or axillary (armpit) temperature measurements.
The following are accepted temperature norms:
- Rectal: temperatures above 101.8? F (38.8? C) are considered abnormal.
- Oral: temperatures above 100.2? F (37.8? C) are considered abnormal.
- Axillary: temperatures above 99? F (37.2? C) are considered abnormal.
Each individual's normal temperature varies. It is suggested that temperatures be measured periodically, during times of good health, to establish an individual's personal base temperature. Infants and young children tend to have higher base temperatures while elderly individuals tend to have lower base temperatures.
It is particularly difficult to obtain accurate temperature measurements of infants and children. For this reason it is suggested that parents try to find the most effective and accurate method of temperature measurement that fits their budget.
Where to Find a Thermometer
- While most pharmacies carry the low-tech thermometers, most do not carry a good selection of high-end electronic thermometers.
- Ask your pharmacist or healthcare provider about what thermometers they suggest and any special tips they might have in locating reasonably priced models.
Advantages and Disadvantages
There are a number of factors you should consider when choosing a thermometer for your household: cost, reliability, accuracy, comfort, ease of use, and safety.
Mercury-in-glass thermometers
- Cheap
- Easy to use
- Familiar
- Most accurate of all thermometers when read correctly
- Require at least three to four minutes to obtain an accurate reading
- Recent models contain no absorbable mercury and are non-toxic.
- May present a potential hazard should breakage occur.
- May be difficult to read.
- Must be kept away from excessive heat or direct sunlight to prevent damage.
- Must never be run under hot water.
- Must never be left with unsupervised children or infants.
- Must be disinfected, preferably before and after each use.
Electronic digital thermometers
- Moderately priced
- Easy to read
- Easy to use
- Require up to 30 seconds to obtain a reading
- Very safe
- No more or less accurate than mercury-in-glass thermometers
- Utilize disposable sheaths to eliminate the need for disinfection
- Require batteries
Skin thermometers/temperature strips
- Inexpensive
- Easy to use
- Often prove difficult to interpret
- Noninvasive
- Are less accurate
- Are less reliable
Tympanic membrane blood measurement instruments
- Expensive
- Very accurate
- Comfortable
- Can be performed on a sleeping child
- Require only one second to obtain an accurate reading
- Utilize disposable sheaths to eliminate the need for disinfection
- Measure the temperature of the blood vessels in the ear canal, which is the same as the brain "core" temperature
- Convenient
- Require batteries
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Thermometers and Fever Strips Measure Body Temperature
- These devices can measure changes in body temperature, which can indicate illness.
- Each device works on similar principles but can be used in different ways to measure temperature.
Pre-Reading Precautions for Oral Readings with Mercury-in-Glass Thermometers
- Warning: do not use oral thermometers rectally. There are rectal (security bulb) thermometers designed specifically for taking rectal temperature measurements.
- Inspect the thermometer for cracks or splinters.
- Disinfect the thermometer with alcohol or povidone iodine solution.
- Rinse in cold water. Never rinse in hot water.
- Hold the thermometer at or slightly below eye level to read it.
- Rotate to confirm that the temperature reads below 96? F (35.6? C).
- If not, shake the thermometer with downward, whip-like motions.
- Shake over a bed or carpet to prevent breakage if you drop the thermometer in the course of shaking it.
- Remove food or gum from the mouth of the patient.
- Restrict consumption of cold or hot beverages at least five minutes prior to the reading.
- Restrict vigorous physical activity or smoking at least five minutes prior to the reading.
Performing Oral Readings with Mercury-in-Glass Thermometers
- Place the thermometer under the tongue, slightly to one side of the mouth.
- Lips should be sealed to prevent air from moving over the thermometer.
- About three to four minutes is usually sufficient to obtain an accurate reading.
- Remove the thermometer.
- Wipe saliva off the bulb.
- Read immediately and record.
- Do not let too much time elapse between removal of the thermometer and reading.
Things to Keep in Mind About Oral Readings With Mercury-in-Glass Thermometers
- Warning: Never leave a child or infant unattended with an oral thermometer in his or her mouth. Change in position can cause breakage.
- Do not take oral readings if the patient can only breathe through the mouth or is hyperventilating.
- Do not take oral readings if the patient has recently had surgery performed in the mouth area.
- Do not take oral readings if the patient is any of the following:
- Uncooperative
- Delirious
- Asleep
- Lethargic
- Oral readings with mercury-in-glass thermometers are not suggested for children under age 3.
Pre-Reading Precautions for Rectal Readings with Mercury-in-Glass Thermometers
- Inspect the thermometer for cracks or splinters.
- Disinfect the thermometer with alcohol or povidone iodine solution.
- Rinse in cold water. Never rinse in hot water.
- Hold the thermometer at or slightly below eye level to read it.
- Rotate to confirm that the temperature reads below 96? F (35.6? C).
- If not, shake the thermometer with downward, whip-like motions.
- Shake over a bed or carpet to prevent breakage if you drop the thermometer in the course of shaking it.
- Restrict vigorous physical activity at least five minutes prior to the reading.
- Lubricate the thermometer bulb with a water-soluble lubricant.
Performing a Rectal Reading with a Mercury-in-Glass Thermometer
- Place the child on your lap, face down.
- Separate buttocks with the thumb and forefinger of one hand.
- Gently insert the thermometer:
- The length of the bulb for infants
- One inch for small children.
- The thermometer should be pointed towards the child's navel.
- Warning: never leave a child or infant unattended with a rectal thermometer inserted. Change in position can cause breakage.
- For adults, the patient should lie on one side with legs bent and thighs at a 45-degree angle to the stomach.
- Insert the thermometer 1/2 to two inches into the rectum.
- Request that the patient take a deep breath just prior to insertion.
- Use special caution if the patient has hemorrhoids or has recently experienced severe diarrhea.
- Hold thermometer for at least three minutes.
- Remove the thermometer.
- Wipe the bulb.
- Read immediately and record.
- Disinfect the thermometer with alcohol or povidone iodine solution.
Things to Keep in Mind About Rectal Readings With Mercury-in-Glass Thermometers
- Norms for rectal temperatures are different from norms for oral and axillary temperatures.
- A temperature above 101.8? F (38.7? C) is considered abnormal.
- The risks associated with rectal measurements are:
- Retention of the thermometer in the rectum.
- Perforation
- Injury from broken glass
- Peritonitis
- Rectal measurements are not suggested for infants as they are at greater risk for mucosal perforation.
- Rectal measurements are not suggested for individuals with obstructive hemorrhoids.
- Rectal measurements are not suggested for individuals who have recently had surgery or injury in the rectal area.
Pre-Reading Precautions for Performing an Axillary (Armpit) Reading with a Mercury-in-Glass Thermometer
- Inspect the thermometer for cracks or splinters.
- Disinfect the thermometer with alcohol or povidone iodine solution.
- Rinse in cold water. Never rinse in hot water.
- Hold the thermometer at or slightly below eye level to read it.
- Rotate to confirm that the temperature reads below 96? F (35.6? C).
- If not, shake the thermometer with downward, whip-like motions.
- Shake over a bed or carpet to prevent breakage if you drop the thermometer in the course of shaking it.
- Restrict vigorous physical activity at least five minutes prior to the reading.
Performing an Axillary (Armpit) Reading with a Mercury-in-Glass Thermometer
- Place the thermometer in the armpit.
- Keep the arm pressed to the body for the duration of the reading.
- An accurate reading requires at least 10 minutes.
- Remove.
- Read immediately and record.
Pre-Read Precautions When Performing an Oral Reading with an Electronic Digital Thermometer
- Place a disposable sheath over the thermometer.
- Zero or reset the thermometer.
- Remove food or gum from the mouth of the patient.
- Restrict consumption of cold or hot beverages at least five minutes prior to the reading.
- Restrict vigorous physical activity at least five minutes prior to the reading.
- Restrict smoking at least five minutes prior to the reading.
Performing an Oral Reading with an Electronic Digital Thermometer
- Place the thermometer under the tongue, slightly to one side of the mouth.
- Lips should be sealed in order to prevent air from moving over the thermometer.
- About 30 seconds is usually sufficient to obtain an accurate reading.
- Remove the thermometer.
- Wipe saliva off the bulb/remove disposable sheath.
- Read immediately and record.
Things to Keep in Mind About Oral Readings With Electronic Digital Thermometers
- Do not take oral readings if the patient can only breath through the mouth or is hyperventilating.
- Do not take oral readings if the patient has recently had surgery performed in the mouth area.
Pre-Reading Precautions for Performing a Rectal Reading with an Electronic Digital Thermometer
- Place a disposable sheath over the thermometer.
- Zero or reset the thermometer.
- Restrict vigorous physical activity at least five minutes prior to the reading.
Performing a Rectal Reading with an Electronic Digital Thermometer
- Lubricate the thermometer bulb with a water-soluble lubricant.
- Place the child on your lap, face down.
- Separate buttocks with the thumb and forefinger of one hand.
- Gently insert the thermometer:
- The length of the bulb for infants
- One inch for small children
- The thermometer should be pointed towards the child's navel.
- Warning: never leave a child or infant unattended with a rectal thermometer inserted. Change in position can cause breakage.
- For adults, the patient should lie on one side with legs bent and thighs at a 45-degree angle to the stomach.
- Insert the thermometer one-half to 2 inches into the rectum.
- Request that the patient take a deep breath just prior to insertion.
- Use special caution if the patient has hemorrhoids or has recently experienced severe diarrhea.
- Hold thermometer for at least three minutes.
- Remove the thermometer.
- Wipe the bulb.
- Read immediately and record.
- Disinfect the thermometer with alcohol or povidone iodine solution.
Things to Keep in Mind About Rectal Readings With Electronic Digital Thermometers
- Norms for rectal temperatures are different from norms for oral and axillary temperatures.
- A temperature above 101.8? F (38.7? C) is considered abnormal.
- The risks associated with rectal measurements include the following:
- Retention of the thermometer in the rectum
- Perforation
- Injury from broken glass
- Peritonitis
- Rectal measurements are not suggested for infants as they are at greater risk for mucosal perforation.
- Rectal measurements are not suggested for individuals with obstructive hemorrhoids.
- Rectal measurements are not suggested for individuals who have recently had surgery or injury in the rectal area.
Pre-Reading Precautions for Taking an Axillary (Armpit) Reading with an Electronic Digital Thermometer
- Place a disposable sheath over the thermometer.
- Zero or reset the thermometer.
- Restrict vigorous physical activity at least five minutes prior to the reading.
Performing an Axillary (Armpit) Reading with an Electronic Digital Thermometer
- Place the thermometer in the armpit.
- Keep the arm pressed to the body for the duration of the reading.
- An accurate reading requires at least 30 seconds.
- Remove.
- Read immediately and record.
Performing a Reading with a Skin Thermometer
- Place the strip on the skin -- preferably the forehead -- of the patient.
- Press the strip to the skin for the time suggested by the manufacturer.
- Read immediately and record.
Pre-Reading Precautions for Tympanic Membrane Temperature Devices
- It is best to familiarize yourself with the device beforehand.
- Choose the hand that is most comfortable with handling the device.
- Check batteries.
- Place a disposable sheath over the thermometer.
Performing a Reading Using a Tympanic Membrane Temperature Reading Device
- Do not insert the device until the digital readout signals that it is ready for use.
- Place the instrument in the ear canal.
- Point the tip towards the patient's eye.
- Press the button and wait until the device signals that the reading as been completed.
Things to Keep in Mind About Tympanic Membrane Temperature Reading Devices
- Some people find the more complex models difficult to use.
- Some devices will not function properly if the ambient temperature is too high or too low.
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Keep an Eye On the Thermometer
- Warning: Never leave a child or infant unattended with a rectal or oral thermometer inserted. Change in position can cause breakage.
- Do not let too much time elapse between removal of the thermometer and reading.
- Axillary readings (armpits, etc.) are generally not suggested for infants and children because of their unreliability.
Oral Thermometer Warnings
- Warning: do not use oral thermometers rectally. There are rectal (security bulb) thermometers designed specifically for taking rectal temperature measurements.
- Do not take oral readings if the patient can only breathe through the mouth or is hyperventilating.
- Do not take oral readings if the patient has recently had surgery performed in the mouth area.
- Do not take oral readings if the patient is any of the following:
- Uncooperative
- Delirious
- Asleep
- Lethargic
- Oral readings with mercury-in-glass thermometers are not suggested for children under age 3.
Rectal Thermometer Warnings
- Rectal measurements are not suggested for infants as they are at greater risk for mucosal perforation.
- Rectal measurements are not suggested for individuals with obstructive hemorrhoids.
- Rectal measurements are not suggested for individuals who have recently had surgery or injury in the rectal area.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Books
- 1. American Medical Association. The American Medical Association: Guide to your family's symptoms. Washington, D.C.: American Pharmaceutical Association 1992.
- 2. Fauci, Anthony S. et al. Eds. Harrison's Principles of Internal Medicine, 14th ed. New York: MacGraw Hill 1998.
- 3. Segen, Joseph, and Joseph Stauffer. The Patient's Guide to Medical Tests: Everything you need to know about the tests your doctor prescribes. New York: Facts on File 1998.
- 4. Zaret, Barry L. Et al. The Yale University School of Medicine Patient's Guide to Medical Tests. New York: Houghton Mifflin 1997.
Find more books on health and wellness at  barnesandnoble.com.
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