Claire Dawson
Rectal thermometry is the process of taking a person's temperature by inserting a thermometer into the rectum via the anus. This method is generally considered the most accurate way of temperature-taking, especially for infants and small children who cannot hold a thermometer in their mouth. However, it is also regarded as an invasive and humiliating procedure, so it is often used sparingly and only when necessary. The practice has a long history, dating back to at least the 18th century, and it is still commonly used in hospitals, especially in emergency departments, to assess critically ill or uncooperative patients. While rectal thermometry provides valuable information, there are also concerns about potential rectal injuries and the uncomfortable nature of the procedure.
| Characteristics | Values |
|---|---|
| Accuracy | Rectal temperatures are considered to be the most accurate means of temperature-taking |
| Patient type | Commonly used for infants, small children, and adults for whom taking an oral temperature would be risky or inaccurate |
| History | Rectal thermometry dates back to at least the 18th century |
| Patient experience | Some patients may consider it an invasive or humiliating procedure |
| Technology | As thermometry technology improves, rectal thermometry is becoming less common |
| Comparison | Rectal temperatures can be 2.4 °F, 3.0 °F, and 3.0 °F higher than oral, temporal, and axillary temperatures, respectively |
| Clinical decisions | Patients with higher rectal temperatures were more likely to be admitted to the hospital or the ICU |
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What You'll Learn
- Rectal thermometry is the most accurate way to take a person's temperature
- It is often used on infants, small children, and adults where oral temperature-taking may be risky
- Rectal temperatures are used to detect fever in young children
- Rectal thermometry has been used since at least the 18th century
- Rectal temperatures are often taken in emergency departments
Rectal thermometry is the most accurate way to take a person's temperature
Rectal thermometry is the process of taking a person's temperature by inserting a thermometer into the rectum via the anus. While it is considered invasive and even humiliating by some, it is generally regarded as the most accurate means of temperature-taking.
The practice dates back to at least the 18th century, and it is probable that rectal thermometry was considered a safer alternative to oral temperature-taking due to the use of toxic chemicals in early thermometers. As thermometry technology has improved, rectal thermometry has become less common. However, it is still the preferred method for taking the temperature of infants and young children, and adults where oral temperature-taking is not possible or would be inaccurate.
In the case of infants and small children, they may not be able to hold a thermometer safely in their mouth, so a rectal thermometer is used instead. For adults, rectal thermometry may be used for unconscious patients, post-oral surgery patients, or those suffering from seizures, where oral temperature-taking could risk injury. It may also be used if the patient has recently ingested liquids or is breathing through the mouth, as these factors can affect the accuracy of oral temperature readings.
Several studies have found significant differences between rectal temperatures and non-invasive triage temperatures (oral, axillary, and temporal). Rectal temperatures tend to be higher, and patients with higher rectal temperatures were more likely to be admitted to the hospital or intensive care unit. This suggests that rectal thermometry can provide important information about a patient's condition and may be more effective at detecting fevers than other methods.
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It is often used on infants, small children, and adults where oral temperature-taking may be risky
Rectal thermometry is often used on infants, small children, and adults where oral temperature-taking may be risky. This includes patients who are unconscious, post-oral surgery, or suffering from seizures. It is also used when oral temperature-taking would be inaccurate, such as when the patient has recently ingested liquids or is breathing through the mouth. Rectal temperature readings are generally considered to be more accurate, especially in young children.
The procedure involves inserting a thermometer into the rectum via the anus. While it is considered the most accurate method of temperature-taking, it is also regarded as invasive and humiliating by some. The use of rectal thermometers has a long history in medicine, dating back to at least the 18th century. Early thermometers were made with tube-shaped designs that fit into the anus, and they were likely preferred over oral methods due to the use of toxic chemicals like mercury in oral thermometers.
Despite its routine use, rectal thermometry can be uncomfortable and carry risks. It is recommended that caregivers, whether nurses or mothers, be properly instructed in inserting a rectal thermometer to minimise the risk of injury. Autopsy reports indicate that rectal injuries occur in over 6% of patients, with severe bleeding, ulceration, abscesses, hematomas, and scarring reported as potential complications.
To address safety concerns, thermometer design improvements have been suggested, such as the Scandinavian model with a flat shank that prevents excessive penetration. However, these safer designs have not been widely adopted by manufacturers due to economic considerations. As a precaution, caregivers should never leave a child or debilitated patient unattended with a rectal thermometer in place.
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Rectal temperatures are used to detect fever in young children
Rectal temperatures are considered more accurate than oral, axillary, or temporal routes when detecting a fever in young children. This is because children may be unable to hold a thermometer safely in their mouth, and non-invasive temperature sites may be insensitive due to a variety of factors. Rectal thermometry is also used when taking an oral temperature would be risky, such as with an unconscious patient or someone who has just had oral surgery.
The procedure involves inserting a thermometer into the rectum via the anus, and it is generally regarded as the most accurate means of temperature-taking. However, some may consider it an invasive or humiliating procedure, so it is often used sparingly and primarily on infants and children.
The use of rectal thermometers in medicine dates back to at least the 18th century, and it is probable that they were considered a safer alternative to oral thermometers due to the use of mercury and other toxic chemicals in early thermometers.
Today, electronic thermometers are most often suggested for rectal temperature-taking. These thermometers have an easy-to-read panel and a probe that can be placed in the rectum. To take a child's temperature rectally, petroleum jelly is first placed on the bulb of the thermometer. The child is then placed face down on a flat surface or lap, and the bulb end is inserted about 1/2 to 1 inch (1 to 2.5 centimeters) into the anal canal. It is important to be careful not to insert the thermometer too far, as struggling can push it in further. The thermometer is then left in place for 3 minutes or until the device beeps.
Rectal temperatures are an important tool in paediatrics and can provide vital clues to the etiology of a patient's symptoms.
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Rectal thermometry has been used since at least the 18th century
Rectal thermometry involves taking a person's temperature by inserting a thermometer into the rectum via the anus. Rectal temperatures are generally considered more accurate, especially in young children. This method is also used when taking an oral temperature is risky or impossible, such as with unconscious patients, those who have just had oral surgery, or those suffering from seizures.
Rectal Thermometry: A Historical Practice
The Evolution of Rectal Thermometry
As technology advanced in the 21st century, rectal thermometry became less common. However, it is still the preferred method for specific cases, such as infants, small children, and adults in certain situations. The shape of medical thermometers has also evolved; they are now often designed to be placed in the mouth, armpit, or rectum.
The Accuracy of Rectal Thermometry
Rectal thermometry is widely acknowledged as the most accurate means of temperature-taking. This accuracy is especially important in emergency departments, where retrospective studies have shown significant differences between rectal temperatures and non-invasive triage temperatures in adult patients. These differences can impact clinical decisions, as patients with higher rectal temperatures were more likely to be admitted to the hospital or to require intensive care.
The Future of Rectal Thermometry
While rectal thermometry remains a valuable tool in specific situations, its use is expected to decline further as thermometry-related technology continues to improve.
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Rectal temperatures are often taken in emergency departments
In emergency departments, rectal temperatures are often taken when a fever would significantly alter the management of the patient. This is because fever can provide an important clue to the cause of a patient's symptoms. However, rectal thermometry is considered invasive and embarrassing for the patient, so it is not always the first choice for temperature assessment.
Oral, axillary, and temporal thermometers are frequently used to triage adult patients in emergency departments. However, these methods may not always be accurate. For example, oral readings are often lower than rectal readings, and axillary readings do not adequately approximate core body temperature. In addition, patients may have recently ingested hot or cold liquids, or breathed in cigarette smoke, which can affect the accuracy of oral temperature readings.
Several studies have found significant differences between rectal temperatures and non-invasive triage temperatures. One study found that in almost one in five patients, fever was missed by triage temperature. Another study of 27,130 adult patients found that the mean difference between the initial temperature and the rectal temperature was 1.3 °F, with 25.9% of patients having a rectal temperature that was ≥2 °F higher.
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Frequently asked questions
Rectal temperature is considered the most accurate means of temperature-taking and is often used sparingly on infants, children, or adults for whom taking an oral temperature would be risky or inaccurate.
Rectal temperatures are considered more accurate than oral, temporal, and axillary routes when checking for fever. There was an average difference of 2.4 °F, 3.0 °F, and 3.0 °F between rectal and oral, temporal, and axillary routes, respectively.
Rectal temperature is often taken when a patient is critically ill, or unconscious, or unable to cooperate with standard oral, axillary, or temporal measurements.
A small amount of petroleum jelly is applied to the bulb of the thermometer. The patient is placed on their stomach on a flat surface. The buttocks are spread, and the thermometer is inserted about 1/2 to 1 inch into the anal canal.
Rectal thermometry is considered invasive and humiliating by some. In rare cases, rectal thermometers have been reported to cause severe bleeding, ulceration, abscesses, hematomas, and scarring.
