Fever determination in young infants: prevalence and accuracy of parental palpation.
OBJECTIVE
Pediatricians routinely advise parents to seek immediate medical attention if their young infant develops a fever. Many parents rely on palpation to assess their child's temperature. Our objective was to determine the prevalence and accuracy of parental palpation for fever in young infants.


METHODS
We enrolled a convenience sample of infants younger than 3 months presenting to a pediatric emergency department with any complaint. Parents answered questions regarding their usual fever determination practices and palpated their infants to assess for fever. Parental predictions were then compared with the standard rectal temperature obtained at triage.


RESULTS
Ninety-six infants were enrolled. Fifty-seven percent of parents reported palpation as a usual method of fever assessment, with 87% palpating for fever at least occasionally. Of the 78% of parents who owned a thermometer, nearly half used palpation regularly. As compared with the "gold standard" of rectal thermometry, parental palpation for fever had a sensitivity of 81%, specificity of 82%, positive predictive value of 59% and negative predictive value of 93%. After eliminating from analysis those infants whose parents had used a thermometer at home, we found a sensitivity of 67%, specificity of 84%, positive predictive value of 33%, and negative predictive value of 95%.


CONCLUSIONS
Many parents rely on palpation as a usual method of fever determination in young infants, including nearly half of those who own a thermometer. Parental palpation overestimates the presence of fever, but is likely to be accurate when parents report that their baby is not febrile. As a sole method of determining fever, parental palpation is unreliable.
Katz-Sidlow
Rachel J
RJ
Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA. Rachel.Katz@nbhn.net
Rowberry
Justin P
JP
Ho
Marilyn
M
D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005334:Fever / Q000175:diagnosis*; D005546:Forehead; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008297:Male; D009519:New York City / Q000453:epidemiology; D010173:Palpation / Q000706:statistics & numerical data*; D016487:Parenting / Q000523:psychology; D010290:Parents / Q000523:psychology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013821:Thermometers / Q000706:statistics & numerical data*