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December 2010, Volume 40 Number 12 , p 18 - 19


  • Kathleen J. Dunleavy MSN, MA, RN, CNRN, CNA


MANY TEMPERATURE-RECORDING devices were introduced into hospitals, clinics, and homes when conventional mercury-in-glass thermometers were discontinued around 1990. Our institution used IVAC thermometers (electronic oral/rectal thermometers) for a few years, then chose to stock tympanic thermometers for the inpatient units.In 2005, some nurses became concerned about the accuracy of tympanic thermometers and their efficacy in a neuroscience ICU. Was this product dependable enough for an ICU where temperatures are monitored very closely?To answer this question, we decided to conduct a study to determine what temperature-recording device is most accurate for our patients. But first, let's consider why accurate temperatures are so important in the neuroscience ICU.Both invasive and noninvasive methods of measuring core body temperature are used in the ICU. The pulmonary artery catheter, which measures blood temperature, is considered the gold standard for measuring core temperatures.1 Core body temperature is regulated by both peripheral and central receptors that are integrated within the hypothalamus.2 Autonomic as well as behavioral responses to changes in temperature maintain homeostasis or a range of "normal," around 37[degrees] C.In the neuroscience ICU, we pay extremely close attention to temperature management because hyperthermia can have a profound effect on the brain. Hyperthermia is defined as a temperature greater than 38[degrees] C (100.4[degrees] F).3 This temperature elevation may be deleterious because the byproducts of increased cellular metabolism, including carbon dioxide, may contribute to a rise in intracranial pressure. In critically ill neurologic patients, fever is associated with worse outcomes.3We try to keep febrile patients with brain injury under normothermic conditions (37[degrees] C).4 Under these circumstances, continuous monitoring of temperature in the neurologically injured patient may guide treatment decisions.5Nurses in the neuroscience

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