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Published on: November 21, 2017
Axillary temperatures in full-term newborn infants: using evidence to guide safe and effective practice
Judy Friedrichs1, Beth A Staffileno, Louis Fogg
1Rush University Medical Center (Mss Friedrichs, Hunter, Portugal, Penner, and Peashey and Drs Staffileno, Fogg, and Jegier), Chicago, Illinois; and Ben Taub Hospital (Ms Saunders), Houston Texas.
Purpose:
Although the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists recommend obtaining temperature in newborn infants via the axilla, controversy still exists whether to obtain rectal or axillary temperatures. Of concern is the risk of perforating the rectum or colon during rectal temperature-taking. The purpose of this study was to explore the accuracy of electronic thermometer measuring temperature in the axilla compared with the rectum in full-term newborn infants.
Design:
This was an agreement study involving a purposive sample of newborn infants who were greater than 37 weeks' gestation. The general care nursery was located in a large, urban Midwestern academic medical center, and data collection occurred between May 2010 and August 2010.
Methods:
On admission to the general care nursery, both axillary and rectal temperatures were taken using the FasTemp device by Filac Electronic. Axillary temperatures were taken first, followed immediately by rectal temperature. Descriptive statistics, Pearson correlations, and scatter plots were computed.
Results:
In 69 newborns, the mean difference between rectal and left axilla temperatures was 0.23°C. There was a significant correlation between rectal temperature and the body temperature for the left axilla (r = 0.786; P = .01).
Conclusions:
These preliminary data support the use of left axillary temperature measurement in the full-term newborn infant in the first few days of life to provide a safe and accurate alternative to rectal temperatures.
Clinical Relevance:
Nurses caring for newborn infants now have evidence showing that temperature-taking in the left axilla is an alternative to using rectal temperatures, possibly minimizing discomfort and potential risk of perforation.
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01:14Temperature Measurement Sites
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01:14Assessing Body Temperature - Axilla
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Step 3: Adjust the patient’s clothing to expose only the axilla. It minimizes...
01:19Assessing Body Temperature - Temporal Artery
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Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's forehead...
01:27Assessing Body Temperature - Rectal
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
01:28Factors Affecting Body Temperature
Factors may include:
01:29Decreased Body Temperature