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Infrared thermometers and infants: The device is hot the baby maybe not
Doris Tham1,2,3, Conor Davis1,4, Sandy M Hopper1,2,5,6
1Emergency Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Infrared thermometers are unreliable for infants under 60 days old. Direct methods like rectal thermometers are better predictors of fever in young infants, reducing unnecessary emergency department visits.
Area of Science:
- Pediatrics
- Medical Devices
- Infectious Disease
Background:
- Febrile infants (<60 days old) have a high risk of serious illness, often necessitating aggressive management.
- Infrared thermometers are widely used but have shown unreliability in young infants.
Purpose of the Study:
- To determine the frequency of infrared thermometer use in febrile infants (<60 days old).
- To assess the progression to documented fever in the emergency department (ED).
- To evaluate the rate of serious illness (meningitis, urinary tract infection, bacteremia).
Main Methods:
- A single-center retrospective chart review of infants (<60 days old) presenting to the ED with pre-hospital fever.
- Audited medical records over a 12-month period.
- Correlated home thermometer type (infrared vs. direct) with peak ED temperature, investigations, treatment, and diagnosis.
Main Results:
- Two-thirds of infants used infrared thermometers at home.
- Infants using infrared thermometers were less likely to have documented fever in the ED (22%) compared to those using direct methods (52%).
- Fever in the ED was a stronger predictor of serious illness than pre-hospital fever alone.
Conclusions:
- Infrared thermometer use is common in young infants but less reliable in predicting fever.
- Direct temperature measurement methods are more accurate for this age group.
- Education on appropriate thermometer use for infants is crucial for healthcare providers and the public.
Aim:
The risk of serious illness in febrile infants (<60 days old) is high, and so fever often warrants aggressive management. Infrared thermometers are unreliable in young infants despite their ubiquity. We aim to describe the: (i) frequency of infrared thermometer usage; (ii) progression to documented fever in the emergency department (ED) and (iii) rate of serious illness (meningitis, urinary tract infection and bacteremia).
Methods:
In this single-centre retrospective chart review at The Royal Children's Hospital, Melbourne, we audited medical records of infants (<60 days old) presenting to the ED with pre-hospital fever on history over a 12-month period. We described the type of thermometer used at home (tympanic or forehead, 'infrared' vs. axillary or rectal, 'direct') correlated to peak temperature in ED, investigations, treatment and diagnosis. The primary outcome was subsequent fever in ED.
Results:
Of 159 infants, two of three had infrared temperature measurement at home. Fifty-one (32.1%) developed fever in ED (direct 28/54, 52% vs. infrared 23/105, 22% RR 2.36 (95% CI 1.52-3.69)). Investigations (75%) and admission (60%) were common. Pre-hospital fever alone was less likely to be associated with serious illness, with fever in ED a much stronger predictor.
Conclusions:
In young infants, infrared thermometer use is common and less likely to predict subsequent fever. Twenty-two percent of infants with fever via infrared measurement had fever in ED. History of fever without confirmation is less likely to signal serious illness. Education to public and health-care providers is required to avoid usage of infrared devices in this population.
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