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Clinical Reference Systems: Pediatric Advisor 10.0
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How to Measure a Temperature
Taking a Child's Temperature
Obtaining an accurate measurement of your child's
temperature requires some practice. If you have questions
about this procedure, ask a physician or nurse to show you
how it's done. Then ask them to watch you do it.
Where to Take the Temperature
Temperatures measured rectally are the most accurate.
Temperatures measured orally, by electronic pacifier, or
by ear canal are also accurate if done properly.
Temperatures measured in the armpit are the least
accurate, but they are better than no measurement.
- An infant less than 3 months old (90 days old):
An armpit temperature is preferred for reasons of
safety and is adequate for screening. If the armpit
temperature is over 99ƒF (or 37.2ƒC), check it with a
rectal temperature. The reason you need to take a
rectal temperature for young infants is that if they
have a true fever, they need to be evaluated
immediately.
- A child less than 4 or 5 years old:
A rectal or electronic pacifier temperature is
preferred. An axillary (armpit) temperature is
adequate for screening if it is taken correctly.
- A child more than 4 or 5 years old:
Take the temperature orally (by mouth).
How to Take Rectal Temperatures
- Shake the thermometer until the mercury line is below
99ƒF (37.2ƒC).
- Have your child lie stomach down on your lap.
- Before you insert the thermometer, put some petroleum
jelly on the end of the thermometer and on the opening
of the anus.
- Insert the thermometer gently into the rectum about
1 inch. During the first 6 months of life, gently
insert the rectal thermometer 1/4 to 1/2 inch
(inserting until the silver tip disappears is about
1/2 inch). Never try to force it past any
resistance. Forcing could damage the bowel.
- Hold your child still while the thermometer is in.
- Leave the thermometer in your child's rectum for
2 minutes.
- After 2 minutes take the thermometer out and read the
temperature by finding where the mercury line ends.
(Rotate the thermometer until you can see the mercury.)
- Fever is a rectal temperature over 100.4ƒF, or 38ƒC.
How to Take Armpit Temperatures
- Shake the thermometer until the mercury line is below
98.6ƒF (37ƒC).
- Place the tip of the thermometer in a dry armpit.
- Close the armpit by holding the elbow against the chest
for 4 or 5 minutes. You may miss detecting a fever if
the thermometer is removed before 4 minutes.
- After 4 or 5 minutes take the thermometer out and read
the temperature by finding where the mercury line ends.
(Rotate the thermometer until you can see the mercury.)
- If you're uncertain about the result, check it by taking
a rectal temperature.
- Fever is an armpit temperature over 99ƒF, or 37.2ƒC.
How to Take Oral Temperatures
- Be sure your child has not had a cold or hot drink in
the last 30 minutes.
- Shake the thermometer until the mercury line is below
98.6ƒF (37ƒC).
- Place the tip of the thermometer under one side of the
tongue and toward the back. An accurate temperature
depends on proper placement. Ask a physician or nurse
to show you where it should go.
- Have your child hold the thermometer in place with his
lips and fingers (not his teeth). He should breathe
through his nose, keeping his mouth closed. If your
child can't keep his mouth closed because his nose is
blocked, suction out the nose.
- Leave the thermometer in the mouth for 3 minutes.
- After 3 minutes take the thermometer out and read the
temperature by finding where the mercury line ends.
(Rotate the thermometer until you can see the mercury.)
- Fever is an oral temperature over 99.5ƒF, or 37.5ƒC.
Types of Thermometers
- Glass (with mercury) thermometers
This type of thermometer has been the standard since
1870. These are the least expensive thermometers. They
have two disadvantages: they measure temperatures slowly
and are often hard to read.
Glass thermometers come in two forms, oral with a thin
tip and rectal with a rounder tip. This difference is
not too important. If necessary, a rectal thermometer
can be used in the mouth as long as the thermometer is
cleaned with rubbing alcohol. An oral thermometer can
be used in the rectum if you are extra careful with
rectal insertion.
- Digital electronic thermometers
Digital electronic thermometers measure temperatures
with a heat sensor and require a button battery.
They measure temperatures quickly, usually in less
than 30 seconds. The temperature is displayed in
numbers on a small screen. The same thermometer can
be used to take both rectal and oral temperatures.
A study in Consumer Reports magazine (January 1988)
found that digital thermometers were more accurate than
glass thermometers. Buy one for your family; they cost
about $10.00.
- Ear thermometers
Many hospitals and medical offices now take your child's
temperature using an infrared thermometer that reads the
temperature of the eardrum. In general, the eardrum
temperature provides a measurement that is as accurate
as the rectal temperature.
The biggest advantage of this thermometer is that it
measures temperatures in less than 2 seconds. It also
does not require cooperation by the child and does not
cause any discomfort. Ear thermometers for use at home
have been developed, but they are expensive.
- Digital electronic pacifier thermometers
The new electronic pacifier thermometers have a heat
sensor and are powered by a button battery. These
pacifiers let you measure oral temperature in younger
children. They are quite accurate if 0.5ƒF is added
to the digital reading. They take approximately 3
minutes to reach a steady state. An added advantage
is their lower cost of $15.
- Temperature strips
Liquid crystal strips put on the forehead have been
studied and have been found to be inaccurate. They
do not detect an elevated temperature in most
children with fever.
Touching the forehead is somewhat reliable for
detecting fevers over 102ƒF (38.9ƒC) but tends to
miss mild fevers.
Conversion of Degrees Fahrenheit (F) to Degrees Celsius (C)
Temperatures can be measured in degrees Fahrenheit (F) or
degrees Celsius (C). The table below shows the temperatures
in degrees Celsius that are equivalent to temperatures
measured in degrees Fahrenheit:
98.6 degrees F = 37 degrees C
99 degrees F = 37.2 degrees C
99.5 degrees F = 37.5 degrees C
99 degrees F = 37.2 degrees C
100 degrees F = 37.8 degrees C
100.4 degrees F = 38 degrees C
101 degrees F = 38.3 degrees C
102 degrees F = 38.9 degrees C
103 degrees F = 39.5 degrees C
104 degrees F = 40 degrees C
105 degrees F = 40.6 degrees C
106 degrees F = 41.1 degrees C
107 degrees F = 41.7 degrees C
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