The human body temperature does not depend on the ambient temperature. This is the most volatile physiological parameter. Temperature fluctuations depend on the time of day (in the morning it is always lower than in the evening) and on age (in infants it is the highest, in the elderly it is lowest), physical activity and other circumstances.
Fluctuations in temperature reflect the state of human health: an increase of half a degree means an acute painful condition or disruption of a vital organ, and a decrease means the presence of chronic pathology or dysfunction.
It is also worth recalling that most popular electronic thermometers have a nickel tip, which can be dangerous for people who are allergic to metal compounds. In this case, use this type of gold-tipped thermometer or use a different type of thermometer. Deuteron ear thermometers have become the most expensive devices, many times more expensive than traditional ones and require replacement of batteries and adapters, and they need to be periodically calibrated or, if damaged, repaired.
How to measure the temperature correctly, let's try to figure it out.
In order to get a complete picture of temperature changes, it is measured twice a day: around 8 am and 7 pm.
Body temperature reflects the temperature of the blood circulating in the vessels. Answering the question of where it is best to measure body temperature, you need to know if it is the same for different organs and tissues, how to measure the temperature correctly in order to get accurate data, and what tools are used for this.
Of course, purchasing and operating costs are not and cannot be the only criteria for choosing the right thermometer. The choice of a device to measure a patient's body temperature depends on a number of factors, including: ease of use, infection control, environment, measurement accuracy, and patient specificity.
S .: Clinical thermometry: possible reasons and possible solutions for electronic, digital thermometer errors. Factors influencing the best choice for periodic clinical temperature assessment. In the autumn-winter period, many patients go to the doctor or pharmacist, feverish. Although this adult symptom is usually taken with some control, elevated temperature in children it is alarming, especially in parents. In this situation, they often expect a doctor to prescribe an antibiotic.
Before measuring the temperature, you should not drink hot drinks, actively move, worry, be in a hot room.
Measurement with a mercury thermometer in the armpit
The most common and correct way to measure body temperature is with a mercury thermometer in the armpit. The mercury tip of the thermometer should fit snugly against the skin, no air should enter the armpit, it should be dry, the shoulder and elbow should be pressed very tightly against the body, and the whole process should take at least 10 minutes.
This method of measuring the temperature is not the most reliable, since the measurement error is 0.1 - 0.3 C, and the temperature in the left armpit is usually higher.
Should fever always be a cause for concern and should it immediately decrease? Fever is a common and persistent fear of a physiological response, a source of great terror throughout the history of medicine. Hippocrates believed that the cause of the disease is an imbalance between four fluids, called humor, and fever “cooked up” the excess of one fluid and thus restored the homeostasis of the system. In most cases, the fever is accompanied by an infectious disease.
The microorganism attacking the host system can be located in different tissues and organs, which leads to focal infection or septicemia. In response, the host's defense mechanisms try to stop this attack and eliminate the pathogenic microorganism. Deviations from laboratory tests and clinical symptoms associated with infection, such as fever, elevated C-reactive protein levels and leukocyte counts, reflect the activity of the host's defense system and can therefore be useful for monitoring results.
Measurement with a mercury thermometer in the groin fold
Some children's doctors, when answering the question of young mothers where it is better to measure the temperature of children, recommend placing a thermometer in the child's groin fold - it is believed that this is safer. The baby is laid on the back, his bent leg is pressed to the body and a thermometer is placed between them.
Measurement with a mercury thermometer in the groin fold
Body temperature is not always the same, and there is no correct value for it. It is formed by the internal environment of the body, which can only function within certain temperature ranges. In fact, the correct temperature is not one value, but a compartment. The most low temperature is about 00, and the maximum is about an hour. It depends on parameters such as measurement location, time of day or personal characteristics. The best way to monitor changes in body temperature is to use the same measurement method and take it at the same anatomical location.
Measurement with a mercury thermometer in the oral cavity
In some Western countries, a mercury thermometer is placed under the patient's tongue for three minutes to measure temperature. However, this is not suitable for every patient. Do not use this method for children, mentally unbalanced people and in the presence of a number of diseases of the ENT organs.
Correct temperature range depending on the measuring location. Fever is an important symptom that helps identify illness and warns of worsening. However, this is often viewed as a separate health problem that requires treatment. From a pathophysiological point of view, this is the result of a higher level of regulation of the "thermostat" or center of thermoregulation, which is located in front of the hypothalamus. Fever should be considered as an important, alarming signal accompanying the developing inflammatory process.
Measurement with a mercury thermometer in the rectum
Another way to measure the temperature - through the anus - is used for small children under 5 years of age, weakened patients, with thermoneuroses, in the case of general hypothermia and unconscious patients. In order to correctly measure the rectal temperature, the patient is placed on his side with bent legs, the thermometer is disinfected with soap and water, shaken, the tip is smeared with petroleum jelly and gently inserted into the rectum. It should be remembered that the indicators will be one degree higher than usual. Measurement rectal temperature not performed for diarrhea, constipation and hemorrhoids. When choosing where to measure body temperature to calculate the days of ovulation and study hormonal levels, the gynecologist recommends that a woman use this method.
Pain and fever are the main symptoms of inflammation, both bacterial and viral, located in the respiratory, urinary, or digestive tract. It is the physiological mechanism that supports the fight against infection. It can have a positive effect on the activity and mobility of white blood cells, the activation of T lymphocytes, slows down the growth of viruses and bacteria, and also supports the acute phase of the body's response to infection. Immune mechanisms activated during a febrile response ensure optimal performance levels.
Measuring the temperature in the ear canal
Quite a rare method, but sometimes, to measure the temperature, they also resort to it, especially in extreme conditions, when there is no other possibility without harm to the victim. The method may be unreliable if there is inflammation in the ear canal.
The terms fever and hyperthermia are often used in a common language, but should be distinguished. Hyperthermia does not depend on the center of thermoregulation. This may be due to increased production of endogenous heat, too long exposure to high ambient temperatures, decreased heat loss, or atropine poisoning. Especially in babies, there is inappropriate child care and overheating with inappropriate clothing and in a room that is too warm. The baby's body intensively absorbs heat from the outside, and the poorly formed sweat glands prevent the outside heat from being effectively removed.
Measurement with an electronic thermometer
Electronic thermometers can be used instead of mercury thermometers. How to correctly measure the temperature with an electronic thermometer is indicated in the instructions: the method of application is almost the same as that of mercury, the only difference is that the result becomes visible much faster.
The downside is that the thermometer itself is much more expensive than mercury, and the battery can fail at the most inopportune moment. In addition, such a thermometer is difficult to disinfect. Where to correctly measure the temperature with an electronic thermometer for various diseases, it is better to check with your doctor.
Measurement of body temperature in the groin fold
One of the first sites used to measure body heat was axillary, although its changes show delays in relation to deep body heat changes, mainly in the early phase of the fever response, when vasodilation causes skin cooling and at the same time increases body heat. In addition, cooling of the skin due to perspiration and evaporation can affect the measurement accuracy. It turns out that the temperature measured in the armpit below the lowest reflects the core temperature of the body.
Measurement with an infrared thermometer
Recently, non-contact infrared thermometers are gaining popularity. It is enough to bring them to the skin, and after a couple of seconds the display will show the result. Their convenience is that in this way you can measure the temperature of a sleeping person or in a serious condition without fear of disturbing him, but still the result can hardly be called reliable, since the influence of the ambient temperature is great.
Oral temperature determination
It is characterized by low reproducibility and low sensitivity for detecting fever. Three phases of a typical fever can be distinguished accompanying uncomplicated infection... The first phase occurs during a rapid increase in body temperature. Apparently, they are called that. diseases such as impaired physical activity, weak feeling, lack of readiness for normal activities and activities, increased sensitivity to pain, drowsiness, lack of appetite and the desire for warmth and additional cover.
Differences in temperature measurement
Comparing the data obtained in one way or another, you can see that there are inconsistencies. For example, the temperature in the mouth and under the arm is different. Why this happens is explained simply: a change in the respiratory rate can change the temperature in oral cavity by 0.5 C. Therefore, the temperature in the mouth and armpit will always differ.
In the second phase, the level of the hypothalamic thermostat is reached, and over time, heat production and transfer and equilibration are achieved. Improvement in well-being and general condition compared to the first phase, although usually not associated with high temperature... In the third phase, the body temperature gradually decreases.
Antipsychotics are also recommended in people who are febrile and have chronic respiratory or cardiovascular disease. According to the American Academy of Pediatrics, the primary goal of antipyretic treatment is to improve the overall well-being of the child, not to lower the temperature to normal. The main point is to relieve symptoms associated with fever, such as cold and chills, malaise, headache and muscles.
In the same way, if we compare the temperature in the armpit and in the butt, whether it is the same, we will see that even a healthy person has a difference of 0.5 - 1 C, since in the rectum it is definitely higher than the temperature of the skin in the armpit. It cannot be argued that any of these indicators is more accurate, since both of them objectively reflect the temperature of different organs. A more significant difference may be associated with the development of diseases of the internal organs.
The most popular antipyretic drugs are used to move the adjustment point to a lower level of thermoregulation. This is only seen during fever. They do not reduce body temperature. When choosing an antipyretic drug, consider the following factors: the patient's condition and concomitant diseases, the possibility of achieving the desired effect, the toxic properties of the therapeutic agent. Most often this symptom contains ibuprofen and paracetamol. Based on scientific evidence, these substances have similar safe and pain-relieving effects, but ibuprofen is a more potent antipyretic and provides a longer fever-free period.
Measuring and monitoring body temperature is an obligatory daily procedure associated with caring for a sick person, since changes and fluctuations in body temperature, especially its increase, indicate the onset of the disease.
In a healthy person, body temperature is constant, with slight fluctuations in the morning and evening hours (36-37 ° C). In the morning the temperature is lower by a few tenths of a degree, and higher in the evening. It is believed that the temperature should not exceed 37 ° C, and its fluctuations are in the range from 0.3 to 1 ° C. This constancy of temperature depends on the processes of heat production and heat transfer. In older people, the temperature is slightly lower, while in children it is slightly higher. In the rectum and vagina, the temperature is 1 ° C higher than the temperature of the skin in the armpit and groin.
When the fever is accompanied by other severe inflammatory symptoms such as pain, congestion, swelling, exudation, as recommended in the treatment of non-choric respiratory infections, the first wave of ibuprofen is recommended. Ibuprofen is contraindicated as an antipyretic drug during chickenpox because it increases the risk of developing strep throat and other infections with herpesvirus, such as infectious mononucleosis... It should also not be used with dehydrated and impaired renal perfusion, as nephrotoxic effects may occur.
There are different types of medical thermometers for measuring body temperature:
- mercury maximum;
- digital;
- instant.
The most widely used thermometers are mercury thermometers, which consist of a glass tube with a capillary inside which is connected to a reservoir filled with mercury. On the scale of the thermometer, divisions are applied - from 34 to 42-43 ° С.The division of the mercury thermometer scale is 0.1 ° С.The mercury medical thermometer is called the maximum, since its capillary has a narrowing, which prevents the reverse movement of mercury into the reservoir at the end of thermal effects on him. Therefore, it displays the highest measured temperature. To return the mercury to the thermometer reservoir, it must be shaken several times. This should be done carefully so as not to drop the thermometer or hit it on nearby objects.
Although blended therapy may be more effective in lowering fever than monotherapy, questions remain about the safety of this practice and its effectiveness in improving well-being as a key indicator of treatment success. Alternative doses of antipyretic drugs may increase the risk of poisoning. Especially ibuprofen, which inhibits the production of glutathione in the concomitant presence of elevated concentrations of paracetamol, can have a toxic effect on the kidneys and liver. The coordination of paracetamol with ibuprofen should only be limited to exceptional situations where one of these substances is not effective.
In addition to mercury medical thermometers, electrothermometers are used - digital and instantaneous, convenient for quickly determining the local temperature of the skin and mucous membranes. Unfortunately, most electrothermometers are "disposable"; the battery cannot be replaced. Thermometers are also available to record body temperature over time.
In case of fever accompanied by normal acute infectionsdifferent methods of non-acologic cooling are used, such as ensuring proper hydration at room temperature, light clothing, moisturizing the skin with warm water with a damp towel, and bathing in water at temperatures below 1-2º.
Physiological cooling treatment has been the subject of a number of studies that have shown a higher incidence side effects compared to paracetamol and no efficacy after one hour of use compared to placebo. Cooling does not affect the hypothalamic mechanism of fever and therefore should precede the use of antipyretic drugs. This combination has been shown to increase the antipyretic effect and accelerate the drop in temperature after one hour of use.
Thermometry
As a rule, thermometry is performed 2 times a day - in the morning on an empty stomach (between 6 and 8 am) and in the evening (between 16-18 hours) before the last meal. At the indicated hours, you can judge the maximum and minimum temperatures. If you need a more accurate idea of \u200b\u200bthe daily temperature, you can measure it every 2-3 hours. The duration of the temperature measurement with the maximum thermometer is at least 10 minutes.
Side effects associated with chilling a child with a high fever, among others. Chills, cold sensation, muscle pain are the result of a "hole" between the sensitivity of the thermoregulatory center cells and the blood temperature. In addition, the addition of refrigeration during fever resuscitation makes it easier to obtain excess heat accumulated.
Fever response to antipyretic therapy should not be used as a prognostic factor to determine if a child is milder. Fever in severe infections also responds well to antipyretic drugs as in milder infections, as evidenced by several prospective studies. Therefore, on this basis, the consequences of infection cannot be differentiated. The elimination of the fever may make the assessment easier because a child who is seriously ill even after the fever falls will look ill, while the clinical picture of a slightly ill child usually improves.
When conducting thermometry, the patient must lie or sit.
Body temperature measurement sites:
- armpits;
- oral cavity (under the tongue);
- inguinal folds (in children);
- rectum (debilitated patients).
Measurement of body temperature in the armpit
Before giving the patient a thermometer, it is necessary to inspect the armpit and wipe it dry. The thermometer is taken out of the container with a disinfectant solution, rinsed with running water and wiped dry. Then shake the thermometer so that the mercury column drops to 35 ° C. The thermometer is positioned so that the mercury reservoir is in contact with the body from all sides at the very depth of the armpit, without moving during the entire measurement time. No laundry should get between the thermometer and the body. The shoulder is pressed tightly against chest Weakened patients need to hold their hand when measuring temperature. After 10 minutes, remove the thermometer and record its readings. After use, the thermometer, if used by several people, is placed in a disinfectant solution, and if the thermometer is individual, it must be washed with warm water and soap, wiped dry and, shaking off the mercury to the initial level, placed in a special case.
Measuring the temperature in the rectum
Indications for measuring the temperature in the rectum are: general cooling of the body, skin lesions and inflammatory processes in the armpits, severe exhaustion of the patient.
Laying the patient on his side with legs tucked into his stomach, put on rubber gloves and remove the thermometer from the container with the disinfectant solution. The thermometer is rinsed with running water and wiped dry. Then shake the thermometer so that the mercury column drops to 35 ° C. The end of the thermometer is smeared with petroleum jelly or any other fat and inserted into the rectum to a depth of 4-5 cm. The buttocks are tightly squeezed around the thermometer. Thermometry is carried out within 5 minutes. After removing the thermometer from the anus, it is thoroughly washed with running water and placed in a container with a disinfectant solution. Then they take off their gloves and wash their hands. The obtained result of thermometry is recorded. It must be remembered that the normal temperature in the rectum is 0.5-1 ° C higher than in the armpit. Contraindications to temperature measurement in this way are stool retention, diarrhea, rectal diseases.
Measuring the temperature in the groin fold
Typically, in the groin fold, thermometry is performed in young children.
The thermometer is removed from the container with a disinfectant solution, washed in running water and wiped dry. Shake the thermometer so that the mercury column drops to 35 ° C. The child's leg is bent at the hip and knee joints, while the thermometer is firmly clamped in the groin fold. Temperature measurement time - 5 min. Remove the thermometer and place it in a container with a disinfectant solution. The result of thermometry is recorded.