If temperature shows 99 degree Fahrenheit on axial Should we add 1 degree
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axillary temperature add 1 degree correction oral rectal equivalent
Axillary Temperature - Should You Add 1 Degree?
Yes, but with nuance. Here is the standard guidance:
The Rule
| Measurement Site | Correction to Oral Equivalent |
|---|---|
| Axillary (armpit) | Add 0.5 to 1°F (or 0.3 to 0.6°C) |
| Oral | Reference standard |
| Rectal / Ear | Subtract ~1°F (they read higher) |
So for 99°F axillary, after adding ~1°F, the oral equivalent is approximately 100°F, which is a low-grade fever.
Why Axillary Reads Lower
The axilla is an external body surface exposed to ambient air. It does not reflect true core temperature as accurately as oral, rectal, or tympanic routes. Axillary temps typically run 0.5-1°F lower than oral and about 1-1.5°F lower than rectal temperature.
Important Clinical Points
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Not perfectly standardized - The Cleveland Clinic recommends adding 0.5 to 1°F. Research has shown the mean axillary-oral difference is about 0.25°C (0.45°F), and the axillary-rectal difference is about 0.43°C (0.77°F).
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Fever thresholds by route:
- Axillary fever: ≥ 99.4°F (37.4°C)
- Oral fever: ≥ 100°F (37.8°C)
- Rectal fever: ≥ 100.4°F (38°C)
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99°F axillary is at the borderline - it may or may not represent a true fever depending on the patient's baseline and context.
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Always tell the clinician which route was used - do not just report "100°F" without specifying you added a correction.
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Axillary is least preferred for accuracy. For confirmation, follow up with oral, tympanic (ear), or rectal measurement when possible.
Bottom Line
- 99°F axillary → add ~1°F → ~100°F oral equivalent → considered a low-grade fever
- Always document the site of measurement
- For infants under 3 months, rectal measurement is preferred and any fever warrants prompt medical attention
What is CTG before lscs
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CTG cardiotocography before LSCS caesarean section pre-operative assessment
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Here is a complete explanation of CTG before LSCS:
CTG (Cardiotocography) Before LSCS
What Is CTG?
CTG is a continuous electronic recording of:
- Fetal Heart Rate (FHR) - via Doppler ultrasound
- Uterine contractions - via tocodynamometer
Together, these two traces help assess fetal wellbeing and detect signs of fetal distress.
Why Is CTG Done Before LSCS?
Before performing a Lower Segment Caesarean Section (LSCS), a CTG is done to:
| Purpose | Detail |
|---|---|
| Confirm fetal wellbeing | Ensure the baby is not already in distress before anaesthesia and surgery |
| Baseline documentation | Record the fetal heart pattern before any intervention |
| Detect silent fetal compromise | Some babies can be hypoxic without obvious clinical signs |
| Guide urgency of surgery | A pathological CTG may upgrade an elective LSCS to an emergency |
| Anaesthetic risk assessment | Abnormal FHR may change anaesthetic decisions |
What a Normal (Reassuring) CTG Shows
A normal pre-LSCS CTG should be reactive/reassuring, with all four features (using the VEAL or DR C BRAVADO framework):
| Feature | Normal Finding |
|---|---|
| Baseline FHR | 110 - 160 bpm |
| Variability | 5 - 25 bpm (beat-to-beat variation) |
| Accelerations | ≥ 2 accelerations (≥15 bpm for ≥15 sec) in 20 minutes |
| Decelerations | None (no late or variable decelerations) |
Classification of CTG
| Category | Meaning |
|---|---|
| Normal / Reassuring | All features normal - proceed with planned LSCS |
| Suspicious / Non-reassuring | One feature abnormal - closer monitoring, possible expediting |
| Pathological | Two or more abnormal features - immediate action, emergency LSCS |
Practical Points
- CTG is done for at least 20-30 minutes pre-operatively
- For elective LSCS, it is done on the day of surgery, usually after admission
- For emergency LSCS, CTG findings often drive the decision - a Category 1 (crash) LSCS is declared when CTG shows immediate threat to fetal life
- If CTG is non-reactive or pathological, delivery is expedited - the surgeon does not wait
- CTG traces are stored as part of the medico-legal documentation for the case
Categories of Emergency LSCS Based on CTG
| RCOG Category | Urgency | CTG Implication |
|---|---|---|
| Cat 1 | Within 30 min | Immediate threat to fetal life (e.g., bradycardia, prolonged deceleration) |
| Cat 2 | Within 75 min | Maternal/fetal compromise not immediately life-threatening |
| Cat 3 | Needing early delivery | No current compromise |
| Cat 4 | Elective timing | No compromise, scheduled |
In summary: CTG before LSCS is a mandatory pre-operative fetal assessment to confirm the baby's condition is stable before anaesthesia. A reassuring CTG allows the team to proceed; an abnormal CTG changes the clinical plan and may require immediate delivery.
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