2. Recognition of infections
Contents
1. armpit armpit measurement is suitable for conditions when all of the above temperature measurement methods are not applicable Page 13 2 4 3 Cleaning and disinfection of thermometers after use e Thermometers cannot be disinfected by heating methods as heat can affect their functions and cause damage Electronic thermometers e There are various types of electronic thermometers in the market Some can be immersed in disinfectant while some cannot To ensure proper maintenance of the thermometers read and follow the user manual for the recommended cleansing and disinfection method Mercury thermometers e Handle oral and rectal thermometers separately e Wash thermometers with cold water and detergent until clean e Immerse in 70 alcohol for at least 10 minutes e Air dry and then store in a clean container with a cover 2 5 What should be done when a resident develops fever If a resident has a temperature higher than the reference value for details please refer to Section 2 3 2 or 1 C of his her baseline separate him her from the others and arrange him her to seek medical advice promptly Staff should record the body temperature in the resident s personal health record as well as mark his her name or bed number in the Residents fever record Appendix C To enhance early detection of outbreak situation the Infection Control Officer ICO is responsible to monitor residents fever record for any unus2. Unexplained changes in behaviour and body functions e g loss of bladder control or faecal incontinence Person with untreated infection may serve as a reservoir and continue spreading the infective agents to the others Thus it is very important to detect infected persons early 2 3 Measuring body temperature 2 3 1 The importance of taking body temperature Most people develop fever when being infected but there are exceptions Some people have lower baseline body temperatures even their body temperatures have raised during infection the body temperatures may still be within the reference range These changes can only be identified when their usual body temperatures are monitored on a regular basis Therefore it is a good practice to check and document the body temperature of high risk residents daily Page 10 Besides residents with the following conditions should have their body temperature checked more frequently e Being feeble e With communication problems e Having symptoms of infection e Recently discharged from hospital e Having been exposed in communicable diseases outbreaks particularly acute respiratory diseases If the temperature deviates from the resident s usual body temperature he she may have an underlying infection 2 3 2 Core and surface temperature Body temperature can be divided into core temperature and surface temperature Core temperature refers to the temperature of deep tissues and can be tak
3. 2 Recognition of infections 2 1 Signs and symptoms of some communicable diseases The typical signs and symptoms of some communicable diseases are listed in Appendix A for quick reference The list is not meant to be exhaustive For more information about different types of communicable diseases please visit the CHP website www chp gov hk Please note that many other diseases may also cause the above signs and symptoms These complaints should be compared with the past health record of the individual As fever is a common presenting symptom residents temperature should be checked regularly and their personal health records should be properly maintained 2 2 Observation and assessment Infections can be identified by observing and monitoring of certain signs and symptoms Staff and carers should pay more attention to those with special health conditions or medical devices as these residents are more prone to infections It is a good practice for the infection control officer ICO to conduct a preliminary health assessment for those who were suspected to have infection with the Checklist on signs and symptoms of infections Appendix B and seek prompt advice from the medical professionals Arrange the resident for urgent medical consultation once he she is found to have the following conditions Disorientation confusion restlessness Weaker than usual Lethargy Fall Shortness of breath Increased or irregular heart rate
4. en through the oral cavity rectum or ears whereas surface temperature is the temperature of surface skin tissues and can be taken through the forehead or armpits Comparatively surface temperature is more easily affected by the surroundings To avoid inaccurate measurement staff should e Be familiar with the correct use of thermometers e Use the same temperature taking method for each resident e Take temperature from the same body part around the same time every day to avoid deviations caused by changes in the surroundings e Defer temperature taking when residents having exercise after bathing or foods and drinks within 30 minutes Body temperature varies with age time of the day and level of physical activity For screening purpose temperature above the reference reading quoted below will be considered as significant and staff should arrange medical consultation for the resident if fever is suspected Measuring method Celsius scale C Fahrenheit scale F Ear 38 0 C 100 4 F Oral 37 5 C 99 5 F Armpit 37 3 C 99 1 F Rectal 38 0 C 100 4 F Page 11 2 4 Proper use of thermometers 2 4 1 Choice of thermometers There are digital mercury and infrared thermometers in the market for oral rectal armpit ear and forehead temperature measurement Accuracy suitability and convenience should all be taken into account in choosing the appropriate thermometer Before using a speci
5. eter from the should be used for ear when it beeps taking temperature 7 Read digital display and record accordingly Oral 1 a concen a Avoid cold or hot a Not applicable for and be ablete close his foods and drinks for persons who are or her mouth tight at least 30 minutes unconscious 2 Cover the thermometer before taking confused or who with a plastic shield temperature cannot close their ie Pie al E If the resident eE thermometer under the lly bit ff tongue near the root a neS o 4 Instruct the person to y close the mouth tight thermometer he she and do not speak or bite should be Sent ie ais on the thermometer hospital immediately 5 Remove the digital without delay thermometer when it beeps and check the reading For a mercury thermometer remove the thermometer after 3 minutes and check the reading 6 Record accordingly Armpit 1 Put the thermometer E Armpit temperature is E Unless for the very under the armpit 2 Place the person s forearm horizontally on the chest to hold the thermometer in position 3 Wait for 6 to 8 minutes before checking the reading 4 Mark the value clearly in record as armpit temperature usually lower than oral temperature a The thermometer should be held tightly under the armpit when taking temperature B Ensure the privacy of the residents and protect them from catching cold when taking temperature thin person with a socket like hollow
6. fic thermometer read the instructions carefully for the proper procedures and the reference range of the readings Infrared forehead thermometers are less accurate in reflecting the true core body temperature although some institutions are using it for the routine temperature checking it should not be the only available thermometers in institutions Whenever in doubt staff should use another type of thermometer to recheck the body temperature To reduce the risk of cross infection allocate a designated thermometer to each resident especially those having an infection Page 12 2 4 2 Methods of taking body temperature Method Steps for measuring Points to note Recommendations Ear 1 Switch on and check the The ear temperature a Non invasive fast functions of ear is usually 0 5 C response time and thermometer higher than the oral with an 2 Cover the probe tip with temperature easy to read a plastic probe cover a Direction of the probe display 3 Stabilise the position of tip should be correct the person s head otherwise it will give a Not applicable for 4 Pull the ear backward an inaccurate person with otitis and upward to straighten reading or with obstruction the ear canal and gently a The ear pressed of ear canal place the probe deep against the pillow caused by ear wax into the ear canal during bed rest has 5 Press the SCAN button higher temperature 6 Remove the so the other ear thermom
7. ual pattern Page 14
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