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Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Rectal thermometry is seen to be accurate, the procedure is however poorly tolerated and invasive, so alternatives have been developed to assist practitioners to monitor temperature. However, in some critically ill people, temperature monitoring may be performed via the rectal route (Figure 4.12).
Thermometry
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The rectal temperature is considered to be the best approximation of core temperature. Its major disadvantages are patient discomfort and the quite definite risk of complications, especially in very young and uncooperative patients. In the infant, a rectal thermometer may cause hemorrhage or even perforation of the rectum or colon;18 peritonitis and pneumoperitoneum have also been reported.19,20 Another complication is the spread of infection from one patient to another by successive use of the same thermometer.21,22 A further potential risk is that rectal stimulation may trigger arrhythmias in cardiac patients. Although considered to be the most accurate estimation of core temperature, rectal temperature may be affected by the blood flow to the lower limbs. During muscular exercise, the rectal temperature rises, whereas the skin temperature falls as a result of sweating.
General physical examination
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Possible hypothermia (temp <35°C/95°F) – confirm with low-reading rectal thermometer:1 Prolonged exposure to cold weather/immersion.2 Hypothyroidism.
Out-of-Hospital Cold Water Immersion for Classic (Non-Exertional) Heat Stroke Guided by Real-Time Core Temperature Monitoring: A Case Series
Published in Prehospital Emergency Care, 2023
Ryan C. Jacobsen, Bryan Beaver, Benjamin Abo
In our local experience, we trained our EMS clinicians to seek out heat stroke patients more aggressively by emphasizing core rectal temperature measurement in any patient exposed to environmental heat and/or exertion accompanied by altered mental status, and to begin cold-water immersion as soon as feasible on scene prior to transport to the ED. We had anticipated that the primary indication for on-scene cold-water immersion would be for exertional heat stroke, as our initial training was focused on using primarily exertional examples (e.g., athletes, construction workers, highway/roadside workers, firefighters). However, through our routine quality assurance processes we found no cases of exertional heat stroke, but instead five patients with classic heat stroke managed via the cold-water immersion protocol. The EMS clinicians using core rectal thermometry were able to identify elevated core temperatures in the setting of heat exposure for those not engaged in strenuous activities, yielding diagnoses of classic heat stroke. The EMS National Model Clinical Guidelines do not differentiate between exertional and classic heat stroke, and therefore our on-scene cold-water immersion was performed regardless of the etiology (4).
Preventing necroptosis by scavenging ROS production alleviates heat stress-induced intestinal injury
Published in International Journal of Hyperthermia, 2020
Li Li, Hongping Tan, Zhimin Zou, Jian Gong, Junjie Zhou, Na Peng, Lei Su, Marc Maegele, Daozhang Cai, Zhengtao Gu
The mice were pretreated either with (experimental condition) or without (control condition) 1.8 mg/kg Nec−1 or 1.9 mmol/kg GSK' 872, or 100 mg/kg NAC (intraperitoneal) 1 h before HS [25–27]. The establishment of heat stressed-animal model was described in detail in our previous study [7,23]. The mice in the HS group were placed in a pre-warmed incubator, maintained at 35.5 ± 0.5 °C with relative humidity of 60 ± 5%, without food and water. Rectal core temperature (Tc) was continuously monitored with a rectal thermometer until the Tc reached 42 °C. The mice in the control group were sham-heated at a temperature of 25 ± 0.5 °C and humidity of 35 ± 5% for a time comparable to that of the HS group. Mice were anesthetized by intraperitoneal injection with a mixture of 13.3% urethane and 0.5% chloralose (0.65 ml/100 g body weight, intraperitoneally), then sacrificed 20 h after HS exposure, and the small intestine (ileum) was isolated.
The impact of whole-body hyperthermia interventions on mood and depression – are we ready for recommendations for clinical application?
Published in International Journal of Hyperthermia, 2019
Kay-U. Hanusch, Clemens W. Janssen
Romeyke [21] studied the effects of whole-body heating in 103 patients (m/w = 2/102, average age 55.2 (10.0)) with fibromyalgia and also diagnosed with severe depression based on criteria from the American Psychiatric Association (DSM-V) and the International Statistical Classification of Disease and Related Health Problems. As part of this quasi-experimental observational study, patients were asked to complete a Patient Health Questionnaire (PHQ-D) with a focus on mental well-being and depression. Study participants received multiple WBH sessions in a Heckel HT-2000 device with Infrared-A lighting for the duration of 50 min and a target temperature of 38.5 °C. Following the intervention, subjects rested for 60 min while being covered with blankets. Core body temperature was measured using a rectal thermometer. When comparing the results to a control group that did not receive hyperthermia interventions, they did not find statistically significant differences between the groups (p = 0.055).