Student HEAS 1000 Temperature ESPN V1.23

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HEAS 1000: Student ESPN checklist TEMPERATURE

Supplies Required: Tempa-Dot, Oral thermometer, Temporal thermometer, gloves, pen, Vital Signs flowsheet and
probe covers for all devices, extra batteries or charging base
Please note – the ESPN component of this checklist is combined with the BP/Apical Pulse/O 2/Resp on a
separate document. Please refer to that document for the ESPN skills required for demonstration.
Maintains Principles of Hand Hygiene throughout the skill.
Verify physician orders to determine the need to assess vital signs

Perform hand hygiene and put on PPE if indicated/required for the route
Introduced self to client and family
Identified client using two identifiers, compared identifiers with information on client’s ID bracelet.
Identified factors that might interfere with temperature measurement, helped client to comfortable position, provide
privacy
Explained the procedure to the client and obtain consent
Assemble equipment on the overhead table within reach
Ensure cliient privacy prior to commencing
Oral Temperature
Using a Thermometer:
Pick up thermometer, verify it has the correct oral probe with blue tip attached (red is for rectal)
Grasp probe, slide probe into probe cover until blue tip pops up, be careful not to
press the ejection button at the top.
Discard probe cover by pushing the ejection button, into the appropriate receptacle.
Using a Tempa-Dot:
Remove Tempa-Dot from the packaging, ensuring to remove by pulling the
exposed handle.
Handle
Place the Tempa-Dot into patient’s mouth under tongue, as far back as possible into
either heat pocket.
The dots can either face up or down.
Ask patient to press down on the thermometer while keeping mouth closed.
HEAS 1000 ESPN CHECKLIST: Temperature Aug 2023 V 1.23

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Wait 60 seconds, but less than 2 minutes, and remove the Tempa-Dot. Wait 10 seconds before reading.
The last blue dot on the matrix indicates the correct temperature.
Discard the Tempa-Dot in the appropriate receptacle.

Axillary Temperature
Axilla:
Position client and gown appropriately.
Raise client’s arm. Inspect axillary area for lesions. If heavy perspiration seen, pat area dry.
Pick up thermometer. Grasp probe properly, slide disposable cover over probe until cover locked, careful not to press
the ejection button at the top.
Place probe in center of axilla, move arm over probe and across chest.
Hold probe in place until audible signal heard, then remove. Discard probe cover by pushing the ejection button, into
the appropriate receptacle.
Using a Tempa-Dot:
Remove Tempa-dot from the packaging, ensuring to remove by pulling the exposed handle.
Place the Tempa-Dot high in the axilla with the dot matrix side against the torso and parallel to the length of the body.
Ask patient to hold the Tempa-Dot in place.
Wait 3 minutes, but less than 5 minutes, ad remove the Tempa-Dot. Wait 10 seconds before reading.
The last blue dot on the matrix indicates the correct temperature. Discard the Tempa-Dot in the appropriate
receptacle.
Tympanic Temperature
Assess for factors that might affect the patient’s temperature. Check for the presence of obvious cerumen in the
client's ear canal. Remove patient’s hearing aid if present.
Ensure client is in appropriate comfortable position, with head turned to side, away from nurse. Right-handed
caregivers should obtain temperature from patient's right ear. Left-handed caregivers should obtain temperature
from client's left ear.
Pick up thermometer. Slide disposable speculum cover over lens tip until cover locked into place, careful not to press
the ejection button at the top.
Hold thermometer in the appropriate hand.
Pull the pinna up and back on adults or older children; this helps straighten the S-shaped curve of the canal.
Fit otoscope probe snugly into canal and do not move.
Press scan button, until audible signal sounds.
Remove device from client’s ear, eject probe cover into appropriate receptacle.
If required, apply fresh probe cover, and repeat process in other ear when needed, waiting 2-3 minutes before
completing temperature check. If needed, use alternative routes.

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Temporal Artery
Temporal: Remove thermometer from case or charger. Place disposable cover on probe or cleanse with organization-
approved equipment cleaner.
Move clients’ hair aside from temporal and earlobe area, ensure patient is comfortable.
Place probe in center of client’s forehead, press and hold the button.
Slide probe properly across client’s forehead, and place probe on neck
behind ear.
Release the button, read temperature.

Non-Contact Infrared Thermometer (NCIT)
Non-contact infrared thermometers (NCITs) measure body temperature from a specific distance by sensing the
energy emitted by humans. NCITs offer a way to take your temperature without touching, unlike traditional
thermometers that require physical contact. NCITs became commonplace during COVID-19 as a means of easy
screening to determine access to businesses and workplaces. NCITs are considered more susceptible to inaccurate
measurements than other thermometers and so should be used for screening purposes only.
To complete with all Temperature Assessments
Inform client of their temperature. Clean thermometer with appropriate equipment/wipes when complete.
Help client to a comfortable position. Ensure cliient safety: call bell in reach, personal items within reach, side rails
raised, bed in lowest position.
Remove gloves, if worn. Perform hand hygiene.
Return thermometer to charger, when applicable, or place in appropriate storage location.
Record client’s current temperature, compared to baseline or acceptable range.
Document in the appropriate documents/electronic documents, as per facility policy
Per the NorQuest vital signs values, normal Oral temperature at rest is anywhere from 36.0-38.0⁰.
Please note that normal values can vary greatly, depending on facility or patient. Please ensure
you follow your facility policies, and ALWAYS use clinical judgment when completing vitals.
**** Please ensure you follow the policies at the facilities in which you practice ****
References:
Jarvis, C. (2024). Physical Examination and Health Assessment - Canadian (4th Edition). Elsevier Health Sciences.
https://www.medicalindicators.com/wp-content/uploads/2020/03/TempaDOT-Technical-Information.pdf

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1

HEAS 1000: Student ESPN checklist TEMPERATURE

Maintains Principles of Hand Hygiene throughout the skill.

Verify physician orders to determine the need to assess vital signs

HEAS 1000 ESPN CHECKLIST: Temperature Aug 2023 V 1.23

Discard the Tempa-Dot in the appropriate receptacle.

HEAS 1000 ESPN CHECKLIST: Temperature Aug 2023 V 1.23

Release the button, read temperature.

HEAS 1000 ESPN CHECKLIST: Temperature Aug 2023 V 1.23

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