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Comparison of temple temperatures with rectal temperatures in children under two years of age
George K Siberry1, Marie Diener-West, Elizabeth Schappell
1Department of Pediatrics, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Insights
Temporal artery thermometers offer a useful screening tool for significant fevers in children aged 3-24 months, though they do not reliably predict exact rectal temperatures. Parent and nurse readings were comparable.
Area of Science:
- Pediatrics
- Medical Thermometry
Background:
- Accurate temperature measurement is crucial for diagnosing fever in infants and children.
- Rectal temperature is considered the gold standard, but noninvasive methods are preferred for ease of use.
Purpose of the Study:
- To assess the agreement between rectal and temporal artery temperature measurements in children.
- To evaluate the temporal artery thermometer as a fever screening tool.
- To compare parent and nurse performance in using the temporal artery thermometer.
Main Methods:
- Compared rectal and temporal artery temperature readings in infants and children.
- Evaluated the temporal artery thermometer's sensitivity and specificity for detecting different fever thresholds.
- Assessed agreement between parent and nurse temperature measurements.
Main Results:
- 95% limits of agreement between rectal and temporal artery temperatures were -1.03°C to +1.52°C.
- Parent and nurse temporal artery temperature readings showed good agreement (-0.6°C to +0.7°C).
- A temporal artery temperature cutoff of 37.2°C showed 91% sensitivity for detecting rectal fever ≥38.0°C.
Conclusions:
- Temporal artery temperatures do not reliably predict rectal temperatures.
- The temporal artery thermometer is an effective screen for clinically significant fevers (≥38.5°C and ≥39.0°C) in children 3-24 months.
- Parental use of the temporal artery thermometer yielded results comparable to nurses.
Abstract:
We assessed the agreement between rectal and noninvasive temporal artery temperature measurements in infants and children. We also evaluated the temple thermometer as a screening tool for rectal fever in this age group. Finally, we compared the performance of parents with that of nurses in using the temple thermometer. The 95% limits of agreement between the difference in rectal and average temple temperature were -1.03 and +1.52 degrees C. Mean temple temperatures obtained by parents and by nurses were similar (95% limits of agreement, -0.6 degrees C to +0.7 degrees C). A maximum temple temperature cutoff of 37.2 degrees C (99.0 degrees F) distinguished children with rectal fever of > or =38.0 degrees C with 91% sensitivity and 53% specificity. A cutoff of 37.8 degrees C (100.0 degrees F) distinguished moderate rectal fevers (> or =38.5 degrees C) with 97% sensitivity and 84% specificity. A cutoff of 38.3 degrees C (101.0 degrees F) distinguished a high rectal fever (> or =39.0 degrees C) with a sensitivity of 95% and specificity of 95%. In conclusion, temple temperatures do not reliably predict rectal temperatures, but the temple thermometer can be used as an effective screen for clinically important rectal fever in children 3-24 months old. The findings do not support use of temple temperatures to screen young infants for rectal fever > or =38.0 degrees C. Temperatures obtained by parents were comparable to those obtained by nurses.
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