The vital signs – heart rate, blood pressure, body temperature, respiration rate, and pain – communicate important information about the physiological status of the human body. In this six-part course we explore the anatomy and physiology underlying the vital signs so that you will develop a systematic, integrated understanding of how the body functions. Relevant body systems are reviewed including cardiovascular and respiratory, followed by explanations of how the function of these systems affects vital signs. We discuss normal ranges, normal variants, and the mechanisms that underlie changes in the objective measurement of vital signs. The course also includes demonstrations of appropriate techniques for measuring vital signs in yourself and others. The course is designed for a broad, general audience but will be particularly interesting for individuals working in healthcare, those considering a career as a healthcare professional, lay caregivers, those with an interest in personal health and fitness, or anyone who simply wants to understand how the body functions.
4.5 Assessing Body Temperature Demonstration
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Из курса от партнера University of Pennsylvania
Vital Signs: Understanding What the Body Is Telling Us
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Week 4: Temperature
During week 4 you will learn the definition of mean body temperature and how the body regulates temperature. We will discuss hypothermia and the difference between hyperthermia and fever. Lastly, you will learn how to assess body temperature.
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Connie B. Scanga, PhDPractice Professor
School of Nursing
[BLANK_AUDIO]
Hi, and welcome back to the AMP lab.
So far this week, Dr. Scanga explained thermoregulation, which is the process
which our body uses to maintain a normal homeostasis of heat.
She also talked about mechanisms through which our bodies absorb and lose heat.
We also discussed some of the conditions that arise when our
body can no longer maintain a normal body temperature or core temperature.
Today I'm going to review briefly, how we measure
temperature in a patient in a clinical setting.
And how you may measure temperature on yourself or on a loved one at home.
You can see here I brought a sample of some
of the types of thermometers that are used to measure temperature.
Here, I have a basic, digital thermometer, which is
used to measure oral temperature as well as axillary temperature.
This is a temporal thermometer, which measures temperature in the forehead.
And next to it are some disposable thermometer strips that are
also used along the forehead to estimate temperature in an emergency situation.
And finally, I have a axillary excuse me, this is a tympanic thermometer
which measures temperature via the external auditory canal or ear canal.
So now that I've explained the different devices
we have here let's get back to basics.
So Ryan, why do we want to measure someone's temperature when they're in
a doctor's office or when they're at home and we think that they're sick?
>> When someone comes in a doctor's office, we want to make sure that we
have a, that we know what their
like set temperature is, or like, baseline temperature.
>> Mm-hm.
And another word for baseline is normal, so if someone came
into the doctor's office, or clinician's office for a physical even if
they're healthy, we would measure their temperature to set their baseline,
or normal temperature, so that we know what that, what that is.
And Ryan, this is an excellent point that you brought up.
Because when we are taking someone's temperature, we're not
looking at a set value to determine whether or
not they have a fever or whether or not
they're, they're well or their body is thermoregulating properly.
Right?
We're comparing our reading to their baseline, or normal temperature.
So one of the challenges with measuring temperature is doing
it accurately every time, doing it the same way every time.
One of the problems that we often have
with taking oral temperature is placement in the mouth.
Sometimes you'll see, I'm going to demonstrate on Naomi here.
You'll see a patient or you'll set up a loved one with a thermometer, and the
thermometer will be like this, or like this,
sticking out of their mouth at odd angles.
And ideally, we want to place the probe of a thermometer, this is the
portion that, that actually takes the reading,
in a space called the sublingual pocket.
That's towards the back of their tongue, underneath
their tongue between their teeth and their tongue.
It's this, it's called the sublingual pocket again.
The reason that we're doing that, is it's,
that position is close to the sublingual artery.
The sublingual artery is a deep artery.
And Naomi, what is that, what might that tell us?
>> It's going to be able to
more accurately show your core body temperature.
>> Right, because that artery runs close to the core of our body, right?
Now how about if I have the thermometer in the front of
your mouth, like behind your incisors, near the front of your tongue?
It's further away from the artery so the temperature will probably be lower.
>> Right, and it would be inaccurate.
Great job.
Now this is something you might see at home.
It's a called a temporal thermometer.
It's very quick and it's very easy to use.
What we do is we run the probe over the
patient's forehead, very quickly and it gives us a reading.
Now how it's able to give us a reading is it runs close to the temporal artery.
Now I'm not going to quiz you guys on
this, but here's the temporal artery, right here.
That's again, that's a deep artery that gives us a good
idea of how it runs close to the core of the body.
Now, finally, I have the tympanic thermometer.
Now, this is not as popular as it was, once was, when it was first developed.
[SOUND].
>> It's a little complicated to use.
But once you get the, the, once you get
it placed properly it's actually a very quick reading.
It's placed in the external auditory canal.
Okay?
And in order to get the probe up against the tympanic membrane, or the ear drum,
you often have to pull the patient's ear back and apply some pressure to the probe.
And that can be uncomfortable, it could be difficult to do accurately.
Now the advantage of this, part from it being very quick, is
it brings us close to a very important region of the brain.
Now, ladies and gentlemen, what is the
region of the brain that regulates our temperature?
Naomi?
>> The hypothalamus.
>> The hypothalamus, which is in this region here.
Now if I swing our model around again, [NOISE].
[BLANK_AUDIO]
[NOISE] And I'll pull the probe out.
[SOUND] Here we go.
[NOISE] What is that probe very close to?
Brian?
>> Because it's next to the tympanic
membrane, it's in close proximity to the hypothalamus.
>> Right.
So that's going to give us a very
accurate reading of the core temperature, provided that
we have it positioned correctly, which as I
mentioned, is a little bit difficult to do.
So there are two more ways of measuring temperature that
you might see at home that I want to talk about.
The first is an axillary temperature.
The axilla is an, an anatomical term for the armpit.
We use the same type of thermometer as you do
for an oral temperature, and you place it in the axilla
up against bare skin, hold the body close.
Hold the arm close to the body, and take a reading.
Now, can you guys see that there might
be some problems with measuring temperature this way?
Lydia, you're nodding your head.
What are some, what are some problems that you, that you foresee?
>> well, since it's on the outside of the body, it's not particularly close to
a deep artery, so the reading might not be very close to the core temperature.
>> Excellent.
Right.
And what if a a patient is sweating profusely?
There could be, there could be some interaction with the probe,
but the real problem with taking a temperature this way is placement.
It's actually not that easy to place a thermometer, and
get it to stay there, deep into a patient's armpit.
It's not particular comfortable, and a provider, or a parent might not
have time to sit there and make sure that you're not fidgeting.
The second way of measuring temperature, that you might see at home,
which I don't have an example of here, is a rectal thermometer.
So we're not going to be demonstrating that today.
This requires that a rectal thermometer is placed inside
of the patient's rectum, and temperature temperature reading is made.
There's a lot of problems with this way, too.
It's very accurate when it's placed properly.
Just like with the tympanic thermometer, it requires practice and
training how to appropriately and safely place a rectal thermometer.
So it's very close to the core.
So Naomi, you're going to get a, an accurate reading.
But it's difficult to convince someone to sit
still long enough to have it placed properly.
And it might be uncomfortable for them especially if
they're felling very ill, to wait until their temperature's read.
Formerly we would see this a lot in pediatric patients.
It was understood as the best way and
most accurate way to measure a child's temperature.
And this is before the advent of the temporal thermometer, and the temp, the
tympanic thermometer, which are much easier and
less invasive than taking a rectal temperature.
Do you guys have any questions about these methods of taking temperatures?
No?
Thank you so much for your excellent answers.
I hope that we've explained some of the underpinning
anatomy and physiology behind this very important vital sign.
Temperature is something that seems very simple,
at first, and after Dr. Scanga's lectures,
and our demonstration, you can see how
complicated thermoregulation and our body's temperature really is.
[BLANK_AUDIO]
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