title: Temperature measurements in trauma patients: is the ear the key to the core?
abstract: BACKGROUND
  It is important to monitor the core temperature in a severely injured patient. The choice of method is controversial, and different thermometers and sites for measurement are used. The aim of this study was to investigate continuous epitympanic temperature measurement using an auditory canal sensor in potentially severely injured patients and to compare this method with other commonly used devices.
  
  
  METHODS
  In this cohort of potentially severely injured patients, the core temperature was registered continuously using an epitympanic sensor in the auditory canal, beginning at the accident scene through the first hours after admittance to the hospital. According to clinical practice, other methods of measurement were employed during pre- and in-hospital diagnostics and therapeutics. The consistency between different methods was analysed using Bland-Altman plots, and the limits of agreement (LOA) and bias between methods was estimated.
  
  
  RESULTS
  During the study period, 18 patients were included. A total of 393 temperature measurements were obtained using seven different methods. We found that temperature measurements in the auditory canal agreed satisfactorily with most other types of measurements. The most consistent measurement was observed with bladder measurements (bias 0.43 °C, LOA -0.47, 1.33 °C), which was constant over the temperature range investigated (30.0-38.3 °C).
  
  
  CONCLUSIONS
  Epitympanic temperature measurement in potentially severely injured patients was consistent with other methods that were commonly used to measure core temperature. The difference between measurement methods appeared to be constant over the relevant temperature range. Continuous epitympanic thermometry can be considered a reliable, cost-effective and simple alternative compared with more invasive methods of thermometry.
authors.affiliation: Department of Emergency Medicine and Pre-hospital services, St. Olav`s University Hospital, N-7006, Trondheim, Norway. oddvar.uleberg@stolav.no.|Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. oddvar.uleberg@stolav.no.
authors.forename: O
authors.initials: O
authors.lastname: Uleberg
authors.affiliation: Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: S C
authors.initials: SC
authors.lastname: Eidstuen
authors.affiliation: Department of Emergency Medicine and Pre-hospital services, St. Olav`s University Hospital, N-7006, Trondheim, Norway.|Norwegian Armed Forces, Medical Services, Sessvollmoen, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Vangberg
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.|Department of Anaesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Skogvoll
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature / Q000502:physiology*; D002648:Child; D004424:Ear Canal / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011446:Prospective Studies; D012007:Rectum / Q000503:physiopathology; D015203:Reproducibility of Results; D013821:Thermometers; D014947:Wounds and Injuries / Q000175:diagnosis / Q000503:physiopathology*; D055815:Young Adult