title: The utility of tympanic versus oral temperature measurements of firefighters in emergency incident rehabilitation operations.
abstract: OBJECTIVE
  Emergency incident rehabilitation (EIR) is the process by which firefighters receive medical screening and monitoring as well as oral rehydration while on the scene of intense or extended fire or rescue operations. A crucial parameter in EIR medical monitoring is temperature determination because heat-related illnesses are common. The objective of this study was to compare the use of oral temperature versus infrared tympanic temperature determinations of firefighters in the outdoor environment of EIR operations.
  
  
  METHODS
  This was a prospective observational study of firefighters participating in training scenarios involving heavy smoke and fire conditions at municipal fire training facilities. Outdoor temperature and relative humidity were obtained for each training session. Subjects were outfitted fully for fire fighting duties including full protective clothing and self-contained breathing apparatus (SCBA). Immediately on exiting the fire building, firefighters removed their SCBA masks, protective hoods, and helmets, and had simultaneous oral and tympanic temperatures taken (time 0). The subjects then sat outdoors for 10 minutes and their temperatures were again obtained (time 10). Oral and tympanic temperatures for both time points were calculated as means +/- SD. An intraclass correlation coefficient was calculated to determine how closely the simultaneously obtained oral and tympanic temperatures determinations at T-0 and T-10 correlated with each other.
  
  
  RESULTS
  Forty-two firefighters (mean age, 44.6 years; SD 9.6) were enrolled during four separate training days. There was poor correlation between oral and tympanic temperatures in firefighters both at time 0 (r = 0.10) and at time 10 (r = 0.18).
  
  
  CONCLUSIONS
  There is poor correlation between tympanic and oral temperature determinations in the EIR setting. Oral temperature determinations may be preferable to tympanic temperature determination in the EIR setting.
authors.affiliation: Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104-4283, USA. eddickin@mail.med.upenn.edu
authors.forename: Edward T
authors.initials: ET
authors.lastname: Dickinson
authors.forename: John J
authors.initials: JJ
authors.lastname: Bevilacqua
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Hill
authors.forename: Frank D
authors.initials: FD
authors.lastname: Sites
authors.forename: Fred W
authors.initials: FW
authors.lastname: Wurster
authors.forename: C Crawford
authors.initials: CC
authors.lastname: Mechem
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000502:physiology*; D004638:Emergency Treatment / Q000379:methods*; D005390:Fires / Q000517:prevention & control*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D007318:Inservice Training; D008875:Middle Aged; D009061:Mouth Mucosa / Q000502:physiology*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D010414:Pennsylvania; D011446:Prospective Studies; D011481:Protective Clothing / Q000009:adverse effects; D012106:Research; D013821:Thermometers; D013997:Time Factors; D014432:Tympanic Membrane / Q000502:physiology*