Procedures for Taking Children’s Temperatures

Nanny and Au Pair Health Care Series
By Anne Merchant, Author of The Nanny Textbook

The following instructions are helpful if using a mercury thermometer.

How Long to Leave Thermometer In

When taking a temperature by mouth or the rectum, leave the thermometer in place at least three-minutes. The auxiliary route must leave the thermometer in place for three- to five-minutes to get an accurate reading.

Procedure for Rectal Temperature
For Infants and Toddlers

1. Shake the thermometer down below 96º F and lubricate end with Vaseline or oil.
2. Place the child on their back on a safe comfortable surface.
3. Lift buttocks off the surface by grasping their ankles as if changing a diaper.
4. While child’s buttocks are lifted, insert clean, lubricated, thermometer into rectum, approximately one-half to one-inch. Never force the thermometer! If there is resistance, stop, and use another route to take the temperature.
5. Divert the child’s attention by talking to them during the procedure.
6. Remove, wipe off, and read the thermometer.
7. Write down the reading, notify pediatrician if temperature is 101º F or above.
8. Wash the thermometer in alcohol or with soap and water, dry it, and put in the proper storage place.

Never take a rectal temperature on a child with diarrhea -- use the auxiliary route.

Procedure for Rectal Temperature
For Children Who Can Follow Directions

1. Shake the thermometer down below 96º F and lubricate the end with Vaseline or oil.
2. Turn the child on his or her side. Be certain to provide privacy!
3. Insert the thermometer into the rectum. Do not leave the child alone and continue to hold the end of the thermometer. Do not force a thermometer. Report the inability to insert thermometer to the pediatrician and take the temperature reading using one of the other two routes.
4. Remove the thermometer after three-minutes, wipe off with a tissue, and read. Record the reading and report any significant data.
5. Wash the thermometer in alcohol and tepid water and put in proper place.

Procedure for Oral Temperature

1. Shake the thermometer with three or more brisk jerks of the hand. Be certain never to interchange one thermometer between the mouth and the rectum.
2. Once the mercury is below 96º F place the thermometer under the child’s tongue.
3. Leave in place for at least three-minutes.
4. Wash the thermometer with alcohol and tepid water, dry it, and put it in proper storage place.
5. Wash your hands.
6. Record the reading in the proper place.
7. If the child has a fever, make a notation that the temperature should be re-taken in three hours.
8. Notify the pediatrician if the reading is 101º F or greater.
9. If the child has had something hot or cold to drink, or has been running around or overly excited, wait 15-minutes before taking their temperature.

Procedure for Auxiliary Temperature

1. Shake the thermometer down below 96 ºF.
2. Place under the armpit.
3. Leave in place for three- to five-minutes. Be certain that children hold their arm against their body so the instrument will not fall out.
4. Remove and read.
5. Record and report significant data.


What to Do If Children Have a Temperature

When children have a temperature encourage fluids and give them Tylenol or ibuprofen if the physician orders it. Never give children aspirin unless the doctor specifically orders aspirin. Keep children as quiet as possible. Retake their temperature every two to four hours until the temperature subsides. Convulsions can occur when children have had an elevated temperature.