Accuracy of infrared ear thermometry and traditional temperature methods in young children.
OBJECTIVE
To compare the accuracy of ear-based, rectal, and axillary temperature measurements in comparison to bladder temperature as a core reference.


METHODS
Repeated-measures comparison study.


METHODS
Pediatric critical care settings in two tertiary care hospitals.


METHODS
Thirty children, 1 to 45 months old (mean 16.6 months), who required bladder catheters for their care.


METHODS
Correlation and agreement (mean offset +/- SD) of ear-based, rectal, and axillary temperature measurements with bladder temperature.


METHODS
Ear-based measurements were made with three infrared thermometers in the core mode, both with and without an ear tug. All six readings were made in the same ear in randomized order. Bladder, rectal, and axillary temperatures were read from continuous digital displays immediately after each ear-based measurement.


RESULTS
Ear-based readings correlated relatively well with bladder temperature (r = 0.80 to 0.87), but were lower by means of -0.3 degrees to -0.7 degrees C with moderately high variation (SD = 0.4 degrees to 0.5 degrees C) between children. Use of an ear tug did not affect the readings. Rectal temperature correlated well with bladder values (r = 0.93 to 0.97) and was usually slightly higher (mean offset = 0.2 +/- 0.2 [SD] degrees C), while axillary temperature correlated rather poorly (r = 0.59 to 0.64), with much lower and more variable readings (mean offset = 0.9 degrees +/- 0.6 degrees C). In regard to sensitivity, specificity, and predictive value in screening for fever, rectal readings performed very well, ear-based readings moderately well with some variation, and axillary readings poorly.


CONCLUSIONS
The findings suggest that the additive core-mode adjustments in infrared ear thermometers are too low for young children, an ear tug is not an essential part of measurement technique, rectal temperature closely reflects bladder temperature, and axillary temperature is low and highly variable.
Erickson
R S
RS
School of Nursing, Oregon Health Sciences University, Portland 97201-3098.
Woo
T M
TM
D000367:Age Factors; D000704:Analysis of Variance; D001365:Axilla / Q000502:physiology; D015982:Bias; D001831:Body Temperature / Q000502:physiology*; D002138:Calibration; D002408:Catheters, Indwelling; D002675:Child, Preschool; D004424:Ear Canal / Q000502:physiology*; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007259:Infrared Rays; D008297:Male; D011237:Predictive Value of Tests; D012007:Rectum / Q000502:physiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013821:Thermometers / Q000592:standards*; D001743:Urinary Bladder / Q000502:physiology