INTRODUCTION: The Arizona State Board of Nursing has received questions regarding the scope of practice for RN’s to insert esophageal temperature probes in the management of hypothermia therapy in the ED and CCU settings. It is the intent of the Board of Nursing that these answers will serve to promote safe nursing practice in the insertion of these probes.
BACKGROUND: An accurately-placed esophageal temperature probe provides a core temperature assessment in hypothermia therapy. This information is necessary in order to evaluate the effectiveness of therapy and to validate temperature readings from other monitoring devices. When there a order for an RN to insert an esophageal temperature probe, earlier intervention may be made possible for the patient. Although the procedure is similar to placement of a nasogastric tube, accurate placement is essential.
QUESTION: Is it within the scope of practice for the RN’s to insert an esophageal temperature probe in the management of hypothermia therapy?
ANSWER: It is within the Scope of Practice for a RN with specific education or training to insert an esophageal temperature probe in the management of hypothermia therapy, according to employer/agency policies.
RATIONALE: In order to provide an accurate and reliable temperature assessment, an RN must be able to confidently place the esophageal temperature probe in the correct position within the esophagus. This requires the RN to have a thorough understanding of esophageal anatomy and the effects of an improperly placed probe. Esophageal temperature probes are routinely inserted by RN’s, and evidence shows that this practice promotes early patient care intervention.
C.R. Bard, Inc. (2012) Arctic Sun 5000 Educator’s Tools, Arctic Circle Clinical Education Training Workbook MT08204. www.medivance.com
Mosby’s Skill: Warming and Cooling Devices: External and Intravascular (Excerpted and adapted from Wiegand DL, editor AACN procedure manual for critical care, ed 6, Philadelphia, 2011 Saunders)
Blanchard, H.T. (Oct 2, 2012) EBP Exemplar: Nurse Placement of Esophageal Temperature Probe in the Cardiac Catheterization Lab. Massachusetts General Hospital Patient Care Services Spotlight on Practice. Evidence-Based Practice – Mghpcs.org
Makic, M.B., Lovett, K., & Azam, M. F. (2012). Placement of an esophageal temperature probe by nurses. American Association of Critical-Care Nurses Advanced Critical Care, 23(1), 24-31.