How Should We Measure Body Temperature in the Pediatric Emergency Department? Which One Is the Most Accurate?

Abstract

The aim of this study is to evaluate temperature measurement methods in children. Body temperatures of 3 to 18 years old patients were measured with a tympanic infrared thermometer, a noncontact infrared skin thermometer and with a temporal artery thermometer. While the specificity of temporal artery and noncontact thermometers were good in determination of temperatures above 37.5°C, their sensitivities were low. Positive predictive value and negative predictive value for both thermometers were sufficient. Both specificity and sensitivity of both thermometers were determined to be good at temperature values above ≥ 38°C. It is thought that noncontact and temporal artery thermometers can be used for screening in pediatric emergency departments.

Keywords

temporal artery thermometer - tympanic thermometer - noncontact infrared forehead thermometer - pediatrics - temperature measurement

Informed Consent

Informed consent was obtained from all individual participants included in the study.

• References

• 1 Betz MG, Grunfeld AF. ‘Fever phobia’ in the emergency department: a survey of children's caregivers. Eur J Emerg Med 2006; 13 (03) 129-133
• 2 Rao YK, Midha T, Taneja G, Tripathi VN, Martolia DS, Dwivedi GN. A study on the prognostic value of core to peripheral temperature gradient and blood lactate levels in critically ill children in a tertiary care hospital in Kanpur, India. J Pediatr Infect Dis 2013; 8 (04) 155-159
• 3 Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017: 1363-1367
• 4 Crawford DC, Hicks B, Thompson MJ. Which thermometer? Factors influencing best choice for intermittent clinical temperature assessment. J Med Eng Technol 2006; 30 (04) 199-211
• 5 Chiappini E, Sollai S, Longhi R. , et al. Performance of non-contact infrared thermometer for detecting febrile children in hospital and ambulatory settings. J Clin Nurs 2011; 20 (9–10): 1311-1318
• 6 El-Radhi AS, Barry W. Thermometry in paediatric practice. Arch Dis Child 2006; 91 (04) 351-356
• 7 El-Radhi AS, Patel S. An evaluation of tympanic thermometry in a paediatric emergency department. Emerg Med J 2006; 23 (01) 40-41
• 8 Gasim GI, Musa IR, Abdien MT, Adam I. Accuracy of tympanic temperature measurement using an infrared tympanic membrane thermometer. BMC Res Notes 2013; 6: 194
• 9 Nimah MM, Bshesh K, Callahan JD, Jacobs BR. Infrared tympanic thermometry in comparison with other temperature measurement techniques in febrile children. Pediatr Crit Care Med 2006; 7 (01) 48-55
• 10 Penning C, van der Linden JH, Tibboel D, Evenhuis HM. Is the temporal artery thermometer a reliable instrument for detecting fever in children?. J Clin Nurs 2011; 20 (11–12): 1632-1639
• 11 Lawson L, Bridges EJ, Ballou I. , et al. Accuracy and precision of noninvasive temperature measurement in adult intensive care patients. Am J Crit Care 2007; 16 (05) 485-496
• 12 Davie A, Amoore J. Best practice in the measurement of body temperature. Nurs Stand 2010; 24 (42) 42-49
• 13 Community Paediatrics Committee, Canadian Paediatric Society (2017). Temperature measurement in paediatrics. Available at: https://www.cps.ca/en/documents/position/temperature-measurement . Accessed May 20, 2018
• 14 Davis T. NICE guideline: feverish illness in children--assessment and initial management in children younger than 5 years. Arch Dis Child Educ Pract Ed 2013; 98 (06) 232-235
• 15 Erickson RS, Woo TM. Accuracy of infrared ear thermometry and traditional temperature methods in young children. Heart Lung 1994; 23 (03) 181-195
• 16 Chamberlain JM, Terndrup TE, Alexander DT. , et al. Determination of normal ear temperature with an infrared emission detection thermometer. Ann Emerg Med 1995; 25 (01) 15-20
• 17 Childs C, Harrison R, Hodkinson C. Tympanic membrane temperature as a measure of core temperature. Arch Dis Child 1999; 80 (03) 262-266
• 18 Smith J. Are electronic thermometry techniques suitable alternatives to traditional mercury in glass thermometry techniques in the paediatric setting?. J Adv Nurs 1998; 28 (05) 1030-1039
• 19 Garcia-Souto M, Dabnichki P. Core and local skin temperature: 3–24 months old toddlers and comparison to adults. Build Environ 2016; 104: 286-295
• 20 Kimberger O, Thell R, Schuh M, Koch J, Sessler DI, Kurz A. Accuracy and precision of a novel non-invasive core thermometer. Br J Anaesth 2009; 103 (02) 226-231
• 21 Teran CG, Torrez-Llanos J, Teran-Miranda TE, Balderrama C, Shah NS, Villarroel P. Clinical accuracy of a non-contact infrared skin thermometer in paediatric practice. Child Care Health Dev 2012; 38 (04) 471-476
• 22 Ng DK, Chan CH, Lee RS, Leung LC. Non-contact infrared thermometry temperature measurement for screening fever in children. Ann Trop Paediatr 2005; 25 (04) 267-275
• 23 Allegaert K, Casteels K, van Gorp I, Bogaert G. Tympanic, infrared skin, and temporal artery scan thermometers compared with rectal measurement in children: a real-life assessment. Curr Ther Res Clin Exp 2014; 76: 34-38
• 24 Batra P, Goyal S. Comparison of rectal, axillary, tympanic, and temporal artery thermometry in the pediatric emergency room. Pediatr Emerg Care 2013; 29 (01) 63-66
• 25 Kimberger O, Cohen D, Illievich U, Lenhardt R. Temporal artery versus bladder thermometry during perioperative and intensive care unit monitoring. Anesth Analg 2007; 105 (04) 1042-1047