title: Differences in noninvasive thermometer measurements in the adult emergency department.
abstract: OBJECTIVE
  Detection of accurate temperature in the emergency department (ED) is integral for assessment, treatment, and disposition. The primary objective was to compare temperature measurements from noninvasive temperature devices in the adult ED. The secondary objective was to evaluate the discrepancy between febrile and afebrile patients.
  
  
  METHODS
  This was a prospective observational study of adult patients presenting to the ED. Patients who required a temperature measurement based on standard of care were included. Data collection included oral and temporal artery (TA) temperature measurement taken consecutively. Data were evaluated using the paired Student's t test.
  
  
  RESULTS
  A total of 100 patients were identified. Mean oral temperature was 37.51°C (SD ±1.25), and mean TA temperature was 37.03°C (SD ±0.94). The mean difference was 0.48°C (SD ±0.8), P < .0001. Overall, 49% of patients had a difference in temperature measurements greater than or equal to 0.5°C. There were 47 febrile patients, determined by a measurement greater than 38°C on oral or TA thermometer. The mean temperature difference in these patients was 0.87°C (SD ±0.85) compared with a mean temperature difference of 0.12°C (SD ±0.55) in the afebrile patients, P < .0001. A total of 57% of fevers recorded by the oral thermometer were not recorded by the TA thermometer.
  
  
  CONCLUSIONS
  There was a statistically significant difference in measured temperatures between oral and TA thermometers and a clinically significant difference in 49% of patients. Febrile patients had a greater discrepancy and variability between noninvasive temperature measurements. Caution should be taken when evaluating temperature measurements with these noninvasive devices.
authors.affiliation: Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Bodkin
authors.affiliation: Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY; Department of Pharmacy, University of Rochester Medical Center, Rochester, NY. Electronic address: nicole_acquisto@urmc.rochester.edu.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Acquisto
authors.affiliation: Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Zwart
authors.affiliation: Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY; Department of Emergency Medicine, Rutland Regional Medical Center, Rutland, VT.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Toussaint
mesh_terms: D001831:Body Temperature; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005334:Fever / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D013821:Thermometers / Q000592:standards* / Q000706:statistics & numerical data