title: Accuracy of Tympanic Temperature Measurement in Firefighters Completing a Simulated Structural Firefighting Task.
abstract: BACKGROUND
  In the course of their duties, firefighters risk heat stroke and other medical conditions due to exertion in high-temperature environments. Infrared tympanic temperature measurement (TTym) is often used by Emergency Medical Services (EMS) to assess the core body temperature of firefighters. The accuracy of TTym in this setting has been called into question. Hypothesis/Problem This study aimed to examine the accuracy of TTym for core body temperature assessment at emergency firefighting events compared with gastrointestinal temperature measurement (TGI) as measured by ingestible thermometers.
  
  
  METHODS
  Forty-five (42 male, three female) professional urban firefighters from an Australian fire service completed two 20-minute work periods in a 100°C (± 5°C) heat chamber while wearing personal protective clothing (PPC) and breathing apparatus (weighing approximately 22 kg). Measurements were taken immediately before entering, and on exiting, the heat chamber. Tympanic temperature was assessed by an infrared tympanic thermometer and TGI was measured by ingestible sensor and radio receiver.
  
  
  RESULTS
  Complete data were available for 37 participants. Participant temperatures were higher on exiting the heat chamber than at baseline (TTym: 35.9°C (SD=0.7) vs 37.5°C (SD=0.8); TGI: 37.2°C (SD=0.4) vs 38.6°C (SD=0.5)). Tympanic temperature underestimated TGI on average by 1.3°C (SD=0.5) before entering the chamber and by 1.0°C (SD=0.8) following the exercise. Using pooled data, the average underestimation was 1.2°C (SD=0.7).
  
  
  CONCLUSIONS
  Tympanic thermometers cause an unreliable measure of core body temperature for firefighters engaged in fire suppression activities. Accurate and practical measures of core body temperature are required urgently.
authors.affiliation: 1Australian Capital Territory Ambulance Service,Quality, Safety, and Risk Unit,Canberra,Australia.
authors.forename: Toby
authors.initials: T
authors.lastname: Keene
authors.affiliation: 3National Critical Care and Trauma Response Centre,Disaster Medicine Research,Darwin,Australia.
authors.forename: Matt
authors.initials: M
authors.lastname: Brearley
authors.affiliation: 1Australian Capital Territory Ambulance Service,Quality, Safety, and Risk Unit,Canberra,Australia.
authors.forename: Beth
authors.initials: B
authors.lastname: Bowen
authors.affiliation: 4Australian Capital Territory Fire and Rescue,Department of Justice and Community Safety,Canberra,Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Walker
mesh_terms: D000328:Adult; D001315:Australia; D001831:Body Temperature; D004432:Ear, Middle; D004632:Emergency Medical Services; D005260:Female; D061388:Firefighters; D006801:Humans; D007259:Infrared Rays; D008297:Male; D008875:Middle Aged; D011481:Protective Clothing; D000066908:Simulation Training / Q000379:methods; D013821:Thermometers; D014432:Tympanic Membrane / Q000502:physiology*
keywords: EMS Emergency Medical Services; Emergency Medical Services; PPC personal protective clothing; SCBA self-contained breathing apparatus; TGI
                  gastrointestinal temperature measurement; TTym
                  tympanic membrane temperaturemeasurement; body temperature; firefighters; thermometers