How reliable is axillary temperature measurement?
OBJECTIVE
To assess whether axillary temperature measurements reliably reflect oral/rectal temperature measurements.


METHODS
This observational study compared paired axillary-rectal and axillary-oral temperatures in a general paediatric ward with the participation of 225 children aged < or = 4 y and 112 children aged between 4 and 14 y.


RESULTS
Changes in oral/rectal and axillary temperatures correlated significantly (p < 0.0001). However, axillary temperature measurements were significantly lower than both oral (mean -0.56 degrees C, SD 0.76 degrees C) and rectal measurements (0.38 degrees C; SD 0.76 degrees C). Ninety-five percent of axillary measurements fell within a 2.5-3 degrees C range around respective paired oral/rectal measurements. The mean difference increased with increasing temperature, and was 0.4 degrees C at low body temperatures, and over 1 degree C with a fever of 39 degrees C. Neither seasonal fluctuations nor the amount of clothing worn influenced this difference.


CONCLUSIONS
Axillary temperatures in young children do not reliably reflect oral/rectal temperatures and should therefore be interpreted with caution.
Paediatric Department, St Luke's Hospital, Guardamangia, Malta. amarisfalzon@yahoo.com
A
A
Falzon
V
V
Grech
B
B
Caruana
A
A
Magro
S
S
Attard-Montalto
D000293:Adolescent; D000367:Age Factors; D001365:Axilla; D001831:Body Temperature; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009055:Mouth; D012007:Rectum; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013821:Thermometers