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Temporal Artery Thermometry to Detect Pediatric Fever
Ann Hudson Moore1, Julie Dagenhart Carrigan2, David M Solomon3
1Catawba Valley Medical Center, Hickory, NC, USA amoore@catawbavalleymc.org.
Insights
Temporal artery thermometry (TAT) is not reliable for detecting high fever in children. While it showed promise in injured children, TAT significantly underestimated rectal temperatures in well children, proving clinically unacceptable for fever detection.
Area of Science:
- Pediatrics
- Medical Devices
- Thermometry
Background:
- Accurate temperature measurement is crucial in pediatric care.
- Rectal thermometry is considered the gold standard but poses challenges.
- Temporal artery thermometry (TAT) offers a less invasive alternative.
Purpose of the Study:
- To evaluate the effectiveness of TAT in detecting high rectal fever in children aged 91 days to 4 years.
- To compare TAT measurements with gold-standard rectal temperatures.
- To assess the clinical utility of TAT in different pediatric populations.
Main Methods:
- A comparative study involving 239 children aged 91 days to 4 years.
- Rectal temperature was measured, followed immediately by temporal artery thermometry (TAT).
- Linear regression analysis was used to compare temperature readings and assess discrepancies.
Main Results:
- A significant difference was observed between mean rectal (38.05 ± 0.99 °C) and mean TAT (37.55 ± 0.8 °C) measurements (p < .0001).
- TAT showed a tendency to underestimate rectal temperatures, particularly at higher fever ranges.
- For detecting high fever (≥39 °C) in well children, TAT exhibited 75% sensitivity and 85% specificity, deemed clinically unacceptable.
- In a small cohort of injured children, TAT demonstrated 100% sensitivity and specificity for detecting high rectal fever.
Conclusions:
- TAT is not sufficiently accurate for detecting high fever in well children within the studied age group.
- The underestimation of higher temperatures by TAT limits its reliability for fever screening.
- TAT may hold potential for screening injured children, warranting further investigation to reduce invasive rectal measurements.
Abstract:
This research investigated effectiveness of temporal artery thermometry (TAT) to detect high rectal fever in children ≥ 91 days and ≤ 4 years old. Rectal temperature was initially evaluated immediately followed by TAT. As expected, the difference between mean rectal (38.05 ± .99 °C) and mean TA (37.55 ± .8 °C) temperatures in subjects (N = 239) was significant (p < .0001). Linear regression revealed TAT underestimated rectal thermometry with greater frequency at higher temperatures. This observation provides probable explanation for the disparity between these thermometry methods. A TAT sensitivity of 75% and specificity of 85% were determined for detecting high fever (39 °C)-a finding clinically unacceptable. In contrast, among the small number of injured subjects enrolled, TAT detected high rectal fever with 100% sensitivity and specificity. This finding, if confirmed, suggests TAT screening for well and injured children has potential for clinical practice by diminishing rectal measurements and their associated risks in the acute care and/or ambulatory practice setting.
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