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How to assess an infant’s rectal temperature

Follow these tips to smoothly and efficiently obtain an infant rectal temperature.

Updated Oct. 11, 2018

Fever is a significant vital sign finding in any patient and especially serious in infants. The sudden onset of symptoms — fever, chills, body aches, cough, sore throat, and congestion — may trigger a parent to call for an ambulance.

If you are not a parent or have not worked in an urgent care setting, you may not be familiar with and comfortable taking an infant’s rectal temperature, which will give you the most accurate core body temperature assessment.

Follow these tips to assess rectal temperature in an infant.

  1. Use a specific rectal probe with the thermometer.
  2. Lubricate insertion tip of probe cover with a water-based or petroleum lubricant for patient comfort.
  3. Position infant supine, remove diaper and bring infant’s knees to chest to clearly visualize the anus.
  4. Insert the probe about half an inch into the anus with your right hand. Stop if you meet resistance.
  5. Once inserted, use your left hand to stabilize the probe, if needed, and also use your left arm to keep legs positioned near the infant’s chest. As needed, ask for parent or partner assistance to maintain infant positioning.
  6. Maintain probe position until thermometer indicates temperature assessed.
  7. Remove and clean probe and clean off infant’s bottom with a wipe or tissue.

Finally, for male infants, cover the penis with a towel or diaper to prevent an unexpected splash to your face and uniform contamination during the procedure.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.