Taking Rectal Temperatures of Larger Patients?

This is a question I have for the nurses who’ve had experience with this…..

With larger patients like men or women with big booties that have to get their rectal temperature taken for whatever reason….when the thermometer has been inserted up the rectum and is too short to stick out between the butt cheeks, what is the procedure for making sure it doesn’t slip out or break ? Do you have to hold the thermometer in place between the buttocks? How far up the rectum should a thermometer be inserted for a larger patient or does it matter?

Most adult patients needing their rectal temperature taken for long term maintenance get a narrow, flexible probe inserted 3-5 inches and taped to the buttocks and/or inner thigh to keep it from slipping out. They’re usually unconscious and unaware it’s there. Even when awake they usually can’t feel it.

In the case of heatstroke or hypothermia patients, regardless of age or body size, everyone gets their rectal temperature taken with a hospital grade digital thermometer. The probe is long enough for all body sizes regardless, at least so to do a routine 1-1/2 - 2” insertion.

When using old fashioned mercury rectal thermometers on larger patients, it’s best to have them lie on their left side (left-sims) with the right knee flexed. Raise the right buttock, insert the lubricated thermometer 2” into the rectum, and allow the buttock to go back in place. Gently hold the buttocks together to keep the thermometer from falling out and have the patient lie still for 4 minutes. This is the way we were trained in nursing school in the 1990s, and it’s always worked perfectly.

Nurse Nikki,

Are the older mercury thermometers still used in hospitals. I was under the impression most medical facilities stopped using them. Am I correct?

Thanks.