A5V4d

Feverish illness in children
Some people find rectal thermometers unacceptable for routine use. In newborn babies there have
been reports of injuries including perforation of the bowel after the use of rectal mercury
thermometers. Some people are concerned that electronic thermometers could have the same effect.
In newborn babies taking the temperature in the axilla (armpit) is almost as accurate as using the
rectal route (back passage).
Delphi statement 7.3
Healthcare professionals should routinely use electronic thermometers by the rectal route (back
passage) to measure body temperature in children aged: 0–3 months.
42
1 to 3 4 to 6 7 to 9 Don’t know Missing Total Median
45 (87%) 3 (6%) 3 (6%) 1 (2%) 1 52 1
The statement therefore achieved consensus at the first round of the Delphi technique.
Delphi statement 7.4
Healthcare professionals should not routinely use electronic thermometers by the rectal route (back
passage) to measure body temperature in children aged 3 months to 2 years.
1 to 3 4 to 6 7 to 9 Don’t know Missing Total Median
46 (88%) 4 (8%) 1 (2%) 1 (2%) 1 52 1
The statement therefore achieved consensus at the first round of the Delphi technique.
Delphi statement 7.5
Healthcare professionals should routinely use electronic thermometers by the rectal route (back
passage) to measure body temperature in children aged 2–5 years.
1 to 3 4 to 6 7 to 9 Don’t know Missing Total Median
47 (92%) 3 (6%) 0 1 (2%) 1 52 1
The statement therefore achieved consensus at the first round of the Delphi technique.
Delphi evidence summary
There was a lack of evidence on the relative accuracy or ability to detect fever using the oral and
rectal routes of temperature measurement. The Delphi panel achieved consensus at the first round on
all statements relating to oral and rectal temperature measurements. Eight-five percent of the panel
agreed with the statement that the oral route should not be used routinely in young children. On the
three statements regarding the rectal route, between 87% and 92% of the panel disagreed with the
recommendation that this route should be used routinely. (EL IV)
GDG translation
The GDG considered that the results of the Delphi process indicated strongly that the oral and rectal
routes should not be used for routine temperature measurements in infants and young children.
Recommendations
Number Recommendation
Oral and rectal temperature measurements
1 Do not routinely use the oral and rectal routes to measure the body temperature of
children aged 0–5 years. [2007]