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How reliable is axillary temperature measurement?
1Paediatric Department, St Luke's Hospital, Guardamangia, Malta. amarisfalzon@yahoo.com
Insights
Axillary temperature readings in children are not reliable indicators of core body temperature. These measurements are consistently lower than oral or rectal temperatures and should be interpreted cautiously.
Area of Science:
- Pediatric Medicine
- Clinical Thermometry
- Biomedical Research
Background:
- Accurate body temperature measurement is crucial for diagnosing and managing febrile illnesses in children.
- Axillary temperature measurement is a common, non-invasive method used in pediatric care.
- Concerns exist regarding the accuracy and reliability of axillary temperatures compared to core temperature measurements.
Purpose of the Study:
- To evaluate the reliability of axillary temperature measurements in reflecting oral and rectal temperature readings in pediatric patients.
- To determine the correlation and agreement between axillary and core body temperatures across different age groups.
Main Methods:
- An observational study was conducted in a general pediatric ward.
- Paired axillary-rectal and axillary-oral temperatures were compared in 337 children (225 aged ≤4 years, 112 aged 4-14 years).
Main Results:
- Axillary temperatures were significantly lower than both oral (mean difference -0.56°C) and rectal (mean difference -0.38°C) measurements.
- A significant correlation (p < 0.0001) was observed between changes in axillary and oral/rectal temperatures.
- The discrepancy between axillary and core temperatures increased with rising body temperature, exceeding 1°C at 39°C.
Conclusions:
- Axillary temperature measurements in young children do not reliably reflect oral or rectal temperatures.
- Axillary temperature readings in pediatric populations should be interpreted with caution due to systematic underestimation.
- Further research may be needed to establish appropriate correction factors or alternative methods for accurate temperature assessment in children.
Aim:
To assess whether axillary temperature measurements reliably reflect oral/rectal temperature measurements.
Methods:
This observational study compared paired axillary-rectal and axillary-oral temperatures in a general paediatric ward with the participation of 225 children aged < or = 4 y and 112 children aged between 4 and 14 y.
Results:
Changes in oral/rectal and axillary temperatures correlated significantly (p < 0.0001). However, axillary temperature measurements were significantly lower than both oral (mean -0.56 degrees C, SD 0.76 degrees C) and rectal measurements (0.38 degrees C; SD 0.76 degrees C). Ninety-five percent of axillary measurements fell within a 2.5-3 degrees C range around respective paired oral/rectal measurements. The mean difference increased with increasing temperature, and was 0.4 degrees C at low body temperatures, and over 1 degree C with a fever of 39 degrees C. Neither seasonal fluctuations nor the amount of clothing worn influenced this difference.
Conclusion:
Axillary temperatures in young children do not reliably reflect oral/rectal temperatures and should therefore be interpreted with caution.
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