Equipment 8-864 - Thermometer

CMH EMS & MIH Protocols

Scope of Practice:

• Emergency Medical Responder
• Emergency Medical Technician
• Advanced Emergency Medical Technician
• Registered Nurse
• Paramedic

Indications:

• Protocol 2-924 - Universal Patient Care.

Contraindications:

• None.

Precautions:

• Prehospital thermometers should only be used to measure a patient’s temperature in the oral, axillary, or rectal body sites unless specifically designed for other locations by the manufacturer.
• Do not take a patient’s temperature without using a Welch Allyn disposable probe cover. Doing so can cause patient discomfort, patient cross contamination, and erroneous temperature readings.

Oral Temperature Procedure:

	Using Probe with Blue Ejection Button and Blue Probe Well.
	When used correctly, the SureTemp Plus thermometer accurately measures an oral temperature in approximately 4–6 seconds. The ability of the SureTemp Plus thermometer to take an accurate oral temperature requires correct user technique.
	Holding the probe handle with your thumb and two fingers on the indentations of the probe handle, withdraw the probe from the probe well.
	Verify that the oral model icon is selected by observing the flashing head icon on the instrument’s display. If this icon is not flashing, press the Mode Selection button until the head icon appears.
	Load a probe cover by inserting the probe into a probe cover and pressing the probe handle down firmly. The probe handle will move slightly to engage the probe cover. Use only Welch Allyn probe covers. The use of other manufacturer’s probe covers or no probe cover may produce temperature measurement errors and/or inaccuracy.
	With the Oral Mode indicator flashing, quickly place the probe tip under the patient’s tongue on either side of the mouth to reach the rear sublingual pocket. Have the patient close his/her lips around the probe. Hold the probe in place, keeping the tip of the probe in contact with the oral tissue throughout the measurement process. Rotating "walking" segments appear on the display, indicating that measurement is in progress.
	The unit will beep three times when the final temperature is reached. The measurement site, temperature scale, and patient temperature will display on the LCD. Final temperature will remain on the display for 30 seconds.
	If you cannot correctly measure the patient’s temperature in Normal Mode, the unit will automatically enter Monitor Mode. In this mode, measurement time is extended. Either repeat the temperature measurement in Normal Mode in the opposite sublingual pocket or keep the probe in place for three minutes in Monitor Mode. The thermometer will not beep to indicate a final temperature. Record the temperature before removing the probe from the site, as the temperature reading is not maintained in memory.
	Long-term continuous monitoring beyond three minutes is not recommended in the Oral Mode.
	After the temperature measurement is complete, remove the probe from the patient’s mouth. Eject the probe cover by firmly pressing the ejection button on the top of the probe.
	Return the probe to the probe well. The LCD display will go blank.
	Patient actions may interfere with accurate oral temperature readings. Ingesting hot or cold liquids, eating food, chewing gum or mints, brushing teeth, smoking, or performing strenuous activity may affect temperature readings for up to 20 minutes after activity has ended.

Axillary Temperature Procedure:

	Using Probe with Blue Ejection Button and Blue Probe Well.
	When used correctly, the SureTemp Plus thermometer accurately measures an axillary temperature for pediatric patients (ages 17 and younger) in approximately 10–13 seconds and for adult patients (ages 18 and older) in approximately 12–15 seconds.
	Ensure that the axillary probe (blue ejection button) and the blue probe well are installed.
	Holding the probe handle with your thumb and two fingers on the indentations of the probe handle, withdraw the probe from the probe well.
	Verify that the axillary mode is selected by observing the correct flashing axillary icon on the instrument’s display. If this icon is not flashing, press the Mode Selection button to select the Adult Axillary or Pediatric Axillary icon is displayed.
	To ensure optimal accuracy, always confirm that the correct axillary mode is selected.
	After a temperature is taken and the probe is returned to the probe well, the instrument reverts to the original measurement site mode.
	Do not take an axillary temperature through patient’s clothing. Direct contact between patient’s skin and the probe is required.
	Load a probe cover by inserting the probe into a probe cover and pressing the probe handle down firmly. The probe handle will move slightly to engage the probe cover.
	Use only Welch Allyn probe covers. The use of other manufacturer’s probe covers or no probe cover may produce temperature measurement errors and/or inaccuracy.
	With the correct axillary mode indicator flashing, lift the patient’s arm so that the entire axilla is easily seen. Place the probe as high as possible in the axilla. Do not allow the probe tip to come into contact with the patient until the probe is placed in the measurement site. Before this, any contact between the probe tip and the tissue or other material may cause inaccurate readings.
	Verify that the probe tip is completely surrounded by axillary tissue and place the arm snugly at the patient’s side. Hold the patient’s arm in this position and do not allow movement of the arm or probe during the measurement cycle. Rotating "walking" segments appear on the display, indicating that measurement is in progress.
	The unit will beep three times when the final temperature is reached. The measurement site, temperature scale, and patient temperature will display on the LCD. The final temperature will remain on the display for 30 seconds.
	If you cannot correctly measure the patient’s temperature in Normal Mode, the unit will automatically enter Monitor Mode. In this mode, measurement time is extended. Either repeat the temperature measurement in Normal Mode in the opposite sublingual pocket or keep the probe in place for three minutes in Monitor Mode. The thermometer will not beep to indicate a final temperature. Record the temperature before removing the probe from the site, as the temperature reading is not maintained in memory.
	Long-term continuous monitoring beyond five minutes is not recommended in the Axillary Mode.
	After the temperature measurement is complete, remove the probe from the patient’s axilla. Eject the probe cover by firmly pressing the ejection button on the top of the probe.
	Return the probe to the probe well. The LCD display will go blank.
	Probe contact with electrodes, bandages, etc., poor tissue contact, taking a temperature over clothing, or prolonged exposure of axilla to ambient air can cause inaccurate temperature readings.

Rectal Temperature Procedure:

	Using Probe with Red Ejection Button and Red Probe Well.
	When used correctly, the SureTemp Plus thermometer accurately measures rectal temperature in approximately 10–13 seconds.
	Ensure that the rectal probe (red ejection button) and the red probe well are installed. The instrument will only operate in Rectal Mode when the red rectal probe and probe well are installed.
	Holding the probe handle with your thumb and two fingers on the indentations of the probe handle, withdraw the probe from the probe well.
	Observe the flashing lower-body icon on the unit’s display. Load a probe cover by inserting the probe into a probe cover and pressing the probe handle down firmly. The probe handle will move slightly to engage the probe cover.
	With the Rectal Mode indicator flashing, separate the patient’s buttocks with one hand. Using the other hand, gently insert the probe only 1.5 cm (5/8 in.) inside the rectum (less for infants and children). The use of a lubricant is optional.
	Incorrect insertion of probe can cause bowel perforation.
	Tilt the probe so that the tip of the probe is in contact with tissue. Keep the hand separating the buttocks in place, and hold the probe in place throughout the measurement process. Rotating "walking" segments appear on the display, indicating that measurement is in progress.
	The unit will beep three times when the final temperature is reached. The measurement site, temperature scale, and patient temperature will display on the LCD. The final temperature will remain on the display for 30 seconds.
	If you cannot correctly measure the patient’s temperature in Normal Mode, the unit will automatically enter Monitor Mode. In this mode, measurement time is extended. Either repeat the temperature measurement in Normal Mode in the opposite sublingual pocket or keep the probe in place for three minutes in Monitor Mode. The thermometer will not beep to indicate a final temperature. Record the temperature before removing the probe from the site, as the temperature reading is not maintained in memory.
	Long-term continuous monitoring beyond three minutes is not recommended in Rectal Mode.
	After the temperature measurement is complete, remove the probe from the patient’s rectum. Eject the probe cover by firmly pressing the ejection button on the top of the probe.
	Return the probe to the probe well. The LCD display will go blank.
	Wash your hands. Washing hands greatly reduces the risk of cross-contamination and Nosocomial Infection.

Normal Temperature Ranges

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.