#ir #peds
Rectal temperatures
are the preferred method for infants and young children, however this is uncomfortable
for older children. Oral temperatures are good for children older than 5 who can
cooperate to keep a thermometer under their tongue. Tympanic thermometry uses an
electric thermometer to measure the temperature inside the ear. This is becoming a
popular technique, however measurements may be somewhat variable depending on
how deep in the ear the thermometer goes and interfering factors like ear wax
impaction. Axillary temperature measures the temperature in the armpit. Axillary
measurements are the farthest from the core, and are prone to imprecise and
inaccurate measurements due to factors such as sweat or vasodilation. Rectal, Oral and
Tympanic temperatures give the closest estimate to core temperature, although oral
temperatures tend to be slightly lower than the other two methods. Axillary
temperatures are consistently colder, and have a greater variability.
Developed by Chris Novak, Dr. Mel Lewis and Dr. Peter Gill for pedscases.com
February 15, 2015
Patients, or their parents frequently will report that their child feels warm or has a fever.
Studies have found that subjective reporting does increase the likelihood of a child
having a fever, but fevers should be documented and measured for confirmation,
especially in young children.
Trends with Age: Temperature does not vary significantly with age.
As mentioned earlier, the precise definition of fever varies depending on how you
measure it, however a good cut-off to remember is >38o
C. Fever represents an
infectious process in the majority of cases. However the differential of fever also
includes immune reactions to medications or vaccinations, CNS dysfunction, or chronic
inflammatory conditions like inflammatory bowel disease and juvenile idiopathic arthritis.
Hypothermia or low temperature is due to increased heat loss. Neonates and especially
preterm babies are prone to hypothermia due to an increased body surface area to
body mass ratio and reduced ability to produce heat. In neonates, hypothermia can be
an early indicator of sepsis.
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Approach to Pediatric Vital Signs#13;
Measurement: Temperature varies considerably depending on where it is measured.
Ideally the goal is to measure a person’s core temperature, however the measurements
that we use are surrogates measurements from peripheral sites. <span>Rectal temperatures
are the preferred method for infants and young children, however this is uncomfortable
for older children. Oral temperatures are good for children older than 5 who can
cooperate to keep a thermometer under their tongue. Tympanic thermometry uses an
electric thermometer to measure the temperature inside the ear. This is becoming a
popular technique, however measurements may be somewhat variable depending on
how deep in the ear the thermometer goes and interfering factors like ear wax
impaction. Axillary temperature measures the temperature in the armpit. Axillary
measurements are the farthest from the core, and are prone to imprecise and
inaccurate measurements due to factors such as sweat or vasodilation. Rectal, Oral and
Tympanic temperatures give the closest estimate to core temperature, although oral
temperatures tend to be slightly lower than the other two methods. Axillary
temperatures are consistently colder, and have a greater variability.
Developed by Chris Novak, Dr. Mel Lewis and Dr. Peter Gill for pedscases.com
February 15, 2015
Patients, or their parents frequently will report that their child feels warm or has a fever.
Studies have found that subjective reporting does increase the likelihood of a child
having a fever, but fevers should be documented and measured for confirmation,
especially in young children.
Trends with Age: Temperature does not vary significantly with age.
As mentioned earlier, the precise definition of fever varies depending on how you
measure it, however a good cut-off to remember is >38o
C. Fever represents an
infectious process in the majority of cases. However the differential of fever also
includes immune reactions to medications or vaccinations, CNS dysfunction, or chronic
inflammatory conditions like inflammatory bowel disease and juvenile idiopathic arthritis.
Hypothermia or low temperature is due to increased heat loss. Neonates and especially
preterm babies are prone to hypothermia due to an increased body surface area to
body mass ratio and reduced ability to produce heat. In neonates, hypothermia can be
an early indicator of sepsis.
Pulse Oximetry
Pulse oximetry is a measurement of arterial oxygen saturation or the SPO2. The device
is attached to the child’s finger or ear and uses the differential ab Summary
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