An evaluation of clinical predictors to determine need for rectal temperature measurement in the emergency department.
A cross-sectional study was conducted in an urban emergency department to determine if predictive variables existed that would identify a patient who would be afebrile by oral temperature measurement and febrile by rectal temperature measurement. This study included 366 patients. Five variables studied achieved statistical significance by univariant analysis: mouth breathing (P = .002), respiratory rate (P = .001), supplemental oxygen (P = .009), pulse (P = .0001), and supplemental oxygen via mask (P = .01). Placing these variables in a logistic regression model left two variables that significantly explained the variance of the model: pulse (odds-risk ratio, 1.032/increase in pulse of 1 from 0; 95% confidence interval, 1.020 to 1.039) and mouth breathing (odds-risk ratio, 2.113; 95% confidence interval, 1.41 to 3.43). There was poor linear correlation between oral and rectal temperatures (r = 0.2). If a patient has an unexplained tachycardia and/or is breathing by mouth and is afebrile orally, a rectal temperature measurement should be obtained to determine if fever exists. The results of this study suggest that good linear correlation does not exist between oral and rectal temperature measurements.
Kresovich-Wendler
K
K
Division of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Levitt
M A
MA
Yearly
L
L
D000328:Adult; D001831:Body Temperature; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D009055:Mouth; D009058:Mouth Breathing; D015143:Philadelphia; D011379:Prognosis; D012007:Rectum