I imagine it would be hard to find anything that says not to do rectal temps and I haven't seen anything that is recently published about rectal temps being harmful. For patient's that cannot hold a thermometer in their mouth (which is usually around 2 yrs) best practice is to take a rectal temperature for accuracy if illness is suspected or illness symptoms present. We know elevated HR could be a sign of sepsis in pediatrics, so getting an accurate (rectal in those cases) temp that could show a fever is important. Of course, if there has been a history of anything that would contraindicate a rectal temp we don't (rectal bleeding, rectal surgery, neutropenia hx,...). Do rectal temps take longer and are not fun....yes, but they are communicating to us what is happening in the pediatric patient's body that cannot verbally tell us.
Thank you so much for asking this question! It is so important to get pediatric best practices discussed, seen, and implemented.
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Becca Mielke, MSN, RN, CPEN, TCRN
RN Practice Specialist
Emergency Department
Dell Children's Medical Center
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Original Message:
Sent: 01-21-2026 12:48 PM
From: Cristyn Harrison, RN
Subject: Rectal temperatures
Would anyone be willing to share your hospital policy on rectal temps in children. Focused mostly on birth to 2 years old. I'm trying to gather data to move us away from a "rectal only" temperature policy for under 2 yo. Also, if you know any great literature supporting not using rectal temps that would be great. Thank you!!!!
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Crissi Harrison, RN, BSN, ATC, LAT
Emergency Room Nurse
Nurse Educator for Emergency Department
Charlotte, NC
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