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agency or your local health department. When using tympanic thermometers, too much earwax can cause the reading to be incorrect. Tympanic thermometers may fail to detect a fever that is actually present . Therefore, tympanic thermometers should not be used in children under four months of age, where fever detection is most important.Mercury thermometers can break and result in mercury toxicity that can lead to neurologic injury. To prevent mercury toxicity, the American Academy of Pediatrics encourages the removal of mercury thermometers from homes. This includes all child care settings as well . A collaborative approach in which the primary care provider and the parent/guardian complete the Care Plan and the parent/guardian works with the child care staff to implement the plan is helpful. Although it is usually the primary care provider in the medical home completing the Care Plan, sometimes management is shared by specialists, nurse practitioners, and case managers, especially with conditions such as diabetes or sickle cell disease.Child care health consultants are very helpful in assisting in implementing Care Plans and in providing or finding training

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