COURSE SUMMARY
ANNEX: B
COURSE: MEDICAL
PHASE: 1 VER: D
PREPARATION DATE: 2012/01/23
COURSE TITLE: TREAT UNIT CASUALTIES
REFERENCES: ANA-STP-8-86C-E4-5-SM-TG / (U.S. DOCTRINE STP 8-68W13-SM-TG)
ACADEMIC TITLE
MEASURE A PATIENTS TEMPERATURE
HOURS
081-86A-0013
2 HRS
Terminal Learning Objective:
Measure a casualty's temperature and record the measurement on the appropriate form(s).
Enabling Learning Objectives:
1. Soldier understands how to explain the procedure to the casualty, if necessary.
2. Soldier understands how to inspect and prepare the equipment.
3. Soldier understands how to determine appropriate site, measure and record temp.
MEASURE A PATIENT'S TEMPERATURE
081-86A-0013
Conditions: You have a patient requiring medical assessment. You have performed a patient
care hand-wash. You will need properly disinfected oral and rectal thermometers or an electronic
thermometer, canisters labeled "used," water soluble lubricant, gauze pads, and watch.
Standards: Measure the patient's temperature to the nearest 0.2° F.
Performance Steps
CAUTION: All body fluids should be considered potentially infectious so always observe body
substance isolation (BSI) precautions by wearing gloves and eye protection as a minimal
standard of protection.
1. Determine which site to use.
a. Take an oral temperature if the patient is a conscious adult or child who can follow
directions and can breathe normally through their nose.
CAUTIONS: Do not take an oral temperature when the patient:
(1) Has had recent facial or oral surgery.
(2) Is unable to follow directions (confused, disturbed, or heavily sedated).
(3) Is being administered oxygen by mouth or nose.
(4) Is likely to bite down on the thermometer.
(5) Has smoked, chewed gum or has eaten or drank anything hot or cold within the last
15 to 30 minutes.
b. The tympanic method may be used with conscious or unconscious patients and is the
preferred method if the patient has recently had anything to eat or drink.
CAUTION: Do not attempt to take a tympanic temperature if the patient has had recent facial or
ear surgery or has cerumen (ear wax) impaction.
c. Obtain the patient's temperature by the rectal method if the oral or tympanic methods are
ruled out by the patient's condition.
CAUTION: Do not attempt to take a rectal temperature if the patient has had recent rectal
surgery, unless directed to by a medical officer. Do not attempt to take a rectal temperature on an
infant unless directed by a medical officer.
d. Obtain the patient's temperature by the axillary (least preferred) method if the patient's
condition rules out using the other methods.
2. Select the appropriate thermometer.
a. Tympanic thermometer.
b. Oral thermometer: has a blue tip and may be labeled "Oral."
c. Rectal thermometer: has a red tip and may be labeled "Rectal."
d. Axillary temperatures may be obtained using an oral thermometer.
3. Explain the procedure and position the patient appropriately.
a. Tympanic method. Position the patient with their head turned to make the ear canal easily
accessible.
b. Oral method. Position the patient seated or lying down.
c. Rectal method. Position the patient lying on either side with the top knee flexed.
d. Axillary method. Position the patient either seated or lying face up with the armpit exposed.
4. Measure the temperature.
a. Shake the thermometer several times to ensure it is reading below 94° F.
b. Place the thermometer at the proper site.
(1) Oral method. Place the thermometer underneath the tongue. Instruct the patient
to close their lips around the instrument firmly but not to bite down.
(2) Rectal method. In an adult, insert the thermometer 1 to 2 inches into their rectum.
CAUTION: The rectal thermometer must be lubricated with a water soluble lubricant prior to
insertion. Once inserted, do not let go of the thermometer.
(3) Tympanic method. Pull the ear pinna upward and rearward; insert the thermometer
speculum into the ear canal snugly to create a seal, pointing toward the nose.
(4) Axillary method. Pat the armpit dry and place the bulb end of an oral thermometer in
the center of the armpit with the glass tip protruding to the front of the patient's body.
Place the patient's arm across his chest.
c. Leave the thermometer in place for the required time.
(1) Oral method: must remain in place for at least 3 minutes.
NOTE: If using a digital oral thermometer, leave in place until testing is complete. The digital
unit will normally have an audible tone.
(2) Rectal method: must be held in place for at least 2 minutes.
(3) Tympanic method: must remain in place until an audible signal occurs and the
patient's temperature appears on the digital display.
(4) Axillary method: must remain in place for at least 10 minutes.
5. Remove the thermometer and wipe it down with a gauze pad or discharge the protective
plastic sheath as appropriate.
6. Read the temperature scale or digital display.
7. Evaluate the temperature reading. The normal temperature ranges are as follows:
a. Oral method: 97.0° to 99.0° F.
b. Rectal method: 98.0° to 100.0° F.
c. Tympanic method: 97.0° to 99.0° F.
d. Axillary method: 96.0° to 98.0° F.
8. Place the thermometer in the proper "used" canister or dispose of the plastic sheath as
appropriate.
9. Record the patient's temperature to the nearest 0.2° F on the appropriate medical forms.
Record a rectal temperature with an "R" on the patient's record; with an axillary reading,
use an "A" on the patient's record.
10. Report any significant temperature abnormalities to the supervisor immediately.
Evaluation Preparation:
Setup: To test step 1 for evaluation purposes, create a scenario in which the patient's condition
will dictate which site the Soldier must choose. A tolerance of ± 0.2° F will be allowed during
the evaluation.
Brief Soldier: Tell the Soldier to measure, evaluate, and record a patient's temperature.
Performance Measures
1. Determined an appropriate site to use.
2. Selected the appropriate thermometer.
3. Explained the procedure and positioned the patient.
4. Inserted the thermometer properly and left in place for the appropriate
time.
5. Removed the thermometer and wiped it down with a gauze pad or
discharged the plastic sheath appropriately.
6. Read the temperature scale or digital display.
7. Evaluated the temperature.
8. Placed the thermometer in the proper "used" canister or disposed of the
plastic sheath as appropriate.
9. Recorded the temperature to the nearest 0.2° F correctly on the
appropriate medical forms.
10. Reported any significant temperature abnormalities to the supervisor
immediately.
PASS
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FAIL
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Evaluation Guidance: Score each Soldier according to the performance measures. Unless
otherwise stated in the task summary, the Soldier must pass all performance measures to be
scored PASS. If the Soldier fails any step, show what was done wrong and how to do it correctly.