Tympanic Membrane Temperature with Electronic Thermometer

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: tympanic thermometer, disposable probe cover, and gloves

Perform hand hygiene and put on gloves.
Get the tympanic thermometer from its base unit and apply a disposable probe cover to the earpiece. Be sure the probe cover is secure and locked into place.
Explain the procedure to the patient and ask for his or her assistance in following directions.
Assist the patient in tilting his or her head away from you, so that the ear is directly facing you. Gently pull up and back on the pinna (outside edge of ear) to straighten the ear canal.
Inspect the ear canal for obvious abnormalities before proceeding. If a physical abnormality is present, stop and report it to the medical professional. You may attempt the procedure in the opposite ear, or choose a different method to obtain the patient’s temperature. Do not attempt to remove earwax from the ear canal.
Place the covered probe into the straightened ear canal.
Press the button on the thermometer to begin measuring the patient’s temperature. Hold the thermometer in place until the device indicates measuring is complete (depending on the device model, it may beep or flash).
Gently remove the thermometer and check the temperature reading.
Eject the disposable probe cover into the waste receptacle and return the thermometer to its base unit.
Remove gloves and perform hand hygiene.
Record temperature, method used (tympanic), date, and time in the patient’s chart.
Alert the medical professional of any changes in the patient’s condition.

Important Information

A tympanic membrane thermometer uses an infrared sensor to measure the temperature of the tympanic membrane (ear drum). This type of thermometer is considered an accurate and reliable predictor of a patient’s core temperature because the tympanic membrane’s blood supply is sourced from the carotid artery, which is the same artery that carries blood to the hypothalamus in the brain [1]. However, there are a few situations that can affect the accuracy of a tympanic membrane temperature reading. It is not recommended to use this method if there is a physical deformity of the ear canal, the patient reports ear pain, or excessive earwax, drainage, or sores are present. Tympanic membrane thermometers can be used only to measure tympanic membrane temperatures and should not be used to measure temperatures via the mouth, armpit, or rectum.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658932/

More Resources

Making an Occupied Bed

If a patient is bedridden or on bedrest, the bed linens will need to be changed while the patient is in the bed. For safety reasons, the nurse’s aid should avoid making an occupied bed if the patient is able to get out of bed. Bed linens should be changed according to the facility’s policy or anytime they are wet or soiled.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient.

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.