AIIMS SPECIAL IMAGE BASED QUIZ -4

Temperature

Base Line Data

•       Temperature

•       Pulse

•       Respiration

•       Blood Pressure

•       Pain Assessment – 5^th Vital Sign

TEMPERATURE

Balance between Heat Loss and Heat Production

1. Heat Production (Thermogenesis) – (Posterior Hypothalamus)

1. Oxidation Of Food

•       1g Carbohydrate – 4 Kcal

•       1g Protein– 4 kcal

•       1g Fat – 9 Kcal

•       SDA (Specific Dynamic Action of Food) –

•       Carbohydrate – 5-6 %

•       Protein – 30 %

•       Fat – 4 %

•       Mixed Diet – 12 %

•       ThermoRegulatory Centre - hypothalamus

2. Heat Loss ( Thermolysis ) – (Anterior Hypothalamus)

1. Through Skin
2. Through Lungs – Exhaled Air
3. Through Kidney - Urine
4. Through GIT - Stool

Heat Loss Through Skin

1. Radiation –

•       60% Loss

•       Indirect Contact

B. Evaporation –

•       22% Loss

•       Heat loss by Vapor

C. Convection –

•       Circulation of Air, Flow of Air, 15% Loss

•       E.g. Cooler, Fan

D. Conduction –

•       3 % Loss, Direct Contact

•       E.g. Touching Hot or Cold Surfaces

General points about temperature

•       TEMP. –

•       High in evening

•       Low in Morning

•       Menstrual cycle : Temperature increases  1 °F  during ovulation.

Methods of temp. measurement

1. Oral –

•       Place Thermometer Under Tongue for 2 Minutes

•       Wait for 30 Minutes in case

•       HOT / COLD Foods

•       Chewing Gum

•       Smoking

•       Contraindications

•       Unconscious, Epilepsy, Mask

•       Oral Sx, <6 Yr. Age

2. Rectal – 1 Degree Higher than Oral

•       Sims position (Left Lateral Position)

•       Lubricate Thermometr

•       Insert in Rectum –

•       Adult – 1.5”

•       Child – 1”

•       Time : 5 Minutes

•       Used when Oral Not Possible

•       Contraindications –

•       Diarrhea, Dysentry, rectal Cancer, Sx, Prostate Sx, Hemorrhoids

•       Heart Condition ( Can Stimulate Vagus)

•       Hemophillia, Decreased Platelets

3. Axilla –

•       Ideal for Newborn & Children

•       Place for 5 Minutes

•       1 Degree Less than Oral

Temperature variations in diff. sites

•       Axilla – 97.6 F / 36.4 C

•       Oral – 98.6 F / 37 C

•       Rectal – 99.6 F / 37.5 C

•       Document +1 or -1 F

Thermometer

•       1^st Clinical Thermometr : Thomas Clifford Albert

•       1^st Thermometer : Gallilio Gallies

1. Mercury in glass thermometer

•       Mercury (Hg) is used because-

•       Highly Heat Sensitive

•       Uniform Expansion

•       Oral Thermometer : Bulb – Long, Cylindrical

•       Rectal thermometer _ Bulb – Short , Thick

•       If It breaks Then, Pick By Eye Dropper& Keep in plastic Zipped Bag, Then into 2^nd Bag, Then in 3^rd Bag then send to BMW Department.

•       Marking Of Scale

•       35 – 42 C / 94 – 108 F

•       Direction of Cleaning (Low Infection to High Inf.)

•       Before : Bulb to Stem (BBS)

•       After : Stem to Bulb (ASB)

Disinfection –

•       Dettol / Fairgenol : 1:40  = 5 Min.

•       Savlon :                     1:20 = 5 Min.

•       Lysol / Cresol :         1:40 = 3 Min.

2. Electronic thermometer

•       Reading Time = less than 60 Seconds

•       Safe, Convenient & Easy to Use

3. Tympanic Membrane Thermometer

•       Detects Infra Red (IR) Radiation from Tympanic Membrane

•       Reading Time = 2 Seconds

•       Ideal fo Infant & Young Children

4. Disposable Paper Thermometer

•       Liquid Crystal Chemical Dots

•       Orally – 60 Seconds

•       Axillary / Rectally – 3 Min.

5. Temporal artery thermometer

•       Ideal for Infant

•       Reading Time = 2 Seconds

6. Infra red thermometer

•       Less than 5 Seconds