Ask the Pharmacist
by Ron & Marla Chapleau

April 10, 2016


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Q. What is the best way to take a body temperature to detect a fever?

A. Many of us grew up with a mercury thermometer in our medicine cabinet. Since mercury is toxic, they are no longer a recommended type of thermometer to use. If you still happen to own a mercury thermometer, it is advised to not throw it into the garbage but rather to find a local hazardous waste collection site.

Nowadays, there is a variety of options available to read body temperature and depending on the age of the person; some are more suitable than others. The most common and least expensive thermometer is the digital thermometer (records temperature in one minute or less using electronic heat sensors) and can be used in the rectum, mouth (oral) or the armpit. If you wish to use both the rectal and the oral method, it is important that you do not use the same thermometer for both places. Even if you clean the rectal thermometer, it is strongly advised to have two digital thermometers and clearly mark one for rectal and the other for oral or mouth use.

Rectal temperature provides the most accurate method, especially for young children and infants (digital thermometers can be used rectally in infants), yet least favoured by the parents. To use rectally, lubricate the tip of the thermometer with petroleum jelly and then insert it to 1 inch (1.3 to 2.5 cm) and wait until the thermometer signals to you that it has recorded the temperature.

The armpit method is considered the least accurate reading of the three. If using this method, ensure that the thermometer touches skin and not clothing and also that it is held in place until it signals that it is done.

The oral method is suitable for adults and older children. Since it relies on the person to be able to keep the thermometer in their closed mouth long enough to get an accurate reading, it is not a good choice for younger children or people that are mouth breathers. Keep in mind that food and beverages may affect oral temperature readings so be sure to wait 15 minutes after eating or drinking to take an oral temperature.

Digital ear thermometers (tympanic thermometers) have been on the market for some time now. They use an infrared ray to measure the temperature in the ear canal. The accuracy is dependent on having the correct positioning in the ear and can be affected by difficult (or even impossible) to control factors such as earwax or having a small, curved ear canal. They are more expensive than the regular digital thermometer but many people like the quick response time and ease of use. They are only recommended for people that are older than 6 months of age however.

Temporal artery thermometers (forehead thermometers) are a more recent method of measuring body temperature. It uses an infrared scanner to read the temperature of the temporal artery in the forehead while gently moving the thermometer across the forehead without touching the skin. Like the ear thermometers, they are quick but also expensive. They can be used in people 3 months of age and older, however more recent studies are reporting that it can be used in infants and can provide an accurate alternative to the rectal method (that may put some parents mind at ease).

There are also digital pacifier thermometers that are available but not highly recommended as they need to remain in the mouth for 3-5 minutes to obtain an accurate reading. This is difficult for any child and likely even more troublesome if they are sick.

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In summary, while the rectal thermometer is the most accurate in the very young (which is the age group we are most concerned with when it comes to fever due to the higher risk of complications such as seizures or brain damage) it is not a great deal of fun for either parent nor child. I would suggest a temporal thermometer (which is more accurate than an ear or mouth thermometer) for ease of use, accuracy and the ability to take your childs temperature without waking him/her (a massive, massive advantage!).

You could make an argument to keep a digital thermometer around in case the temperature is higher than you are comfortable with in order to use it rectally to get the most accurate reading but I would suggest if you are getting up to those sorts of temperatures (child less than 3 months of age should be brought with any fever at all , from 3 to 6 months of age a temperature equal to or above 38.3oC and at 6 months or older at 39.4oC or if they have at least 2 accompanying symptoms such as a cough, sore throat, runny you/ stuffy nose, headache, chills, fatigue or diarrhea with a fever of 38.9oC or higher) you should already be bundling up to visit the hospital emergency room.

Now that we discussed the various types of thermometers, it is important to know that normal body temperatures vary depending on the person and also on the method used. Generally, the following temperatures would indicate a fever:

* A rectal, ear or forehead reading of 38C (100.4F) or higher

* An oral reading of 37.8C (100F) or higher

* An armpit reading of 37.2C (99F) or higher

For more information on this or any other topic, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination in Kincardine or Port Elgin Pharmasave.

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Saturday, April 09, 2016