Fever
Medical Author: Dennis S. Phillips, MD
Medical Editors: Dennis Lee, MD and Melissa Conrad Stöppler, MD
There are few things that bring a child to the doctor faster than a fever. Fever is one of the most misunderstood symptoms in all of medicine. Fever serves as one of the body's natural defenses against bacteria and viruses which cannot live at a higher temperature. Also, the body's defense mechanisms seem to work more efficiently at a higher temperature. Fever is just one part of an illness, many times no more important than the presence of other symptoms such as cough, sore throat, etc.
How should I take a temperature for fever?
Measuring an axillary (under the armpit) temperature for fever:
Axillary temperatures are not as accurate as rectal or oral measurements. Studies show that glass thermometers must be left in place for approximately 10 minutes to accurately measure an axillary temperature. An axillary temperature will read approximately 1 degree lower than a simultaneously obtained oral temperature.
Measuring fever by eardrum temperature:
Eardrum temperature measurements are not accurate in small children and should not be used in children under 3 years (36 months) of age. This is especially true in infants below 3 months of age when obtaining an accurate temperature is very important.
Measuring fever by oral temperature:
Older children and adults can have their temperature taken under the tongue with their mouth closed. A standard glass and mercury thermometer should be left in place for at least three minutes. Make sure to shake down the thermometer before using it. The tip of the thermometer should be placed as far back under the tongue as possible. Oral temperatures will be inaccurate if you have had hot or cold drinks within 20 minutes of temperature measurement.
Measuring fever by rectal temperature:
Infants should have rectal temperature measurements. A standard glass and mercury thermometer should be left in place for a minimum of 3 minutes. Make sure to shake down the thermometer before using it. Appropriate care should be taken in inserting, maintaining and withdrawing the rectal thermometer. To take a rectal temperature safely, place the child prone (stomach-side down) on a firm surface. After separating the buttocks, insert a lubricated thermometer approximately 1 inch into the rectum. After at least three minutes, remove the thermometer. A rectal temperature will read approximately 1 degree higher than a simultaneously obtained oral temperature.
Measuring fever by electronic thermometer:
Electronic thermometers that are designed to be used orally (in the mouth) or rectally are an acceptable alternative to a glass thermometer and take a temperature more quickly. They are, however, more expensive than the glass alternative. Strips that measure temperature on the forehead are not accurate and should not be used.
Next: How is fever treated? »
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