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An evaluation of tympanic thermometry in a paediatric emergency department
1Queen Mary's Hospital, Sidcup, Kent DA14 6LT, UK. sahib.el-radhi@qms.nhs.uk
Insights
Tympanic thermometers are more accurate for detecting fever in children than axillary thermometers. This quick and safe method is recommended for pediatric emergency settings.
Area of Science:
- Pediatrics
- Medical Devices
- Clinical Thermometry
Background:
- Accurate fever detection in children is critical due to potentially severe consequences.
- Axillary body temperature measurements are common but often lack accuracy.
- The pediatric emergency setting requires rapid and reliable temperature assessment.
Purpose of the Study:
- To evaluate the accuracy of tympanic thermometers compared to rectal and axillary measurements in infants.
- To determine the reliability of tympanic thermometry in a pediatric emergency environment.
Main Methods:
- A study involving 106 infants compared infrared tympanic thermometer readings with electronic axillary and gold-standard rectal thermometer measurements.
- Fever thresholds were defined for each measurement site (Rectal ≥38.0°C, Axillary ≥37.5°C, Tympanic ≥37.6°C).
- Statistical analysis was performed to compare temperature readings across the three sites.
Main Results:
- Tympanic temperature measurements showed a higher correlation with rectal temperatures than axillary measurements in both febrile and afebrile infants.
- The mean difference between tympanic and rectal readings was significantly lower (0.38-0.42°C) than between axillary and rectal readings (1.11-1.58°C).
- Tympanic measurements demonstrated a sensitivity of 76% for detecting fever (38-38.9°C rectal), compared to only 24% for axillary measurements.
Conclusions:
- Tympanic thermometry offers superior accuracy compared to electronic axillary thermometers for measuring body temperature in children.
- The tympanic method is rapid, safe, and recommended for use in pediatric emergency departments.
- Improved accuracy in fever detection can lead to more timely and appropriate clinical interventions.
Background And Objectives:
The consequences of missing fever in children can be grave. Body temperature is commonly recorded at the axilla but accuracy is a problem. This study aimed to evaluate the accuracy of a tympanic thermometer in the paediatric emergency setting.
Method:
In a total of 106 infants, the body temperature was measured in the daytime with an infrared tympanic thermometer, and at the axilla with an electronic thermometer and at the rectum (gold standard for measurement of body temperature). Fever was defined as a rectal temperature of 38.0 degrees C or greater, axillary temperature of 37.5 degrees C or greater, and tympanic temperature of 37.6 degrees C or greater. The temperature readings at the three sites were compared statistically.
Results:
There was a greater correlation of the tympanic measurement with the rectal measurement than the axillary with the rectal in both febrile and afebrile infants. The mean difference between the tympanic and rectal measurements was lower than that between the axillary and rectal measurements in both groups of infants (tympanic 0.38 degrees C and 0.42 degrees C, and axillary 1.11 degrees C and 1.58 degrees C, respectively). Tympanic measurements had a sensitivity of 76% whereas axillary measurements had a sensitivity of only 24% with rectal temperatures of 38-38.9 degrees C.
Conclusion:
Tympanic thermometry is more accurate than measurement of temperature with an electronic axillary thermometer. It is also quick and safe, and thus it is recommended in the paediatric emergency setting.
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