Accuracy of Temporal Artery Thermometry as an Indicator of Core Body Temperature in Patients Receiving General Anesthesia.

PURPOSE: To evaluate the agreement of temporal artery temperature (Tat) with esophageal temperature (Tes) and oral temperature (Tor), and explore potential factors associated with the level of agreement between the thermometry methods in different clinical settings. DESIGN: A prospective repeated measures (induction, emergence, and postanesthesia care unit) design was used. METHODS: Temperature data were collected for 54 patients receiving general anesthesia. Analyses included descriptive statistics, paired t tests for the within-patient comparison of temperature methods, Bland-Altman plots to examine agreement between methods, and multiple linear regression to identify factors associated with the agreement between methods. FINDINGS: Tat was significantly higher compared with Tes and Tor (P < .05) and was poor at detecting hypothermia. The use of a muscle relaxant and surgical site were suggested to be associated with the difference between Tat and Tes at emergence. CONCLUSIONS: Tat is more convenient, but less accurate, than other thermometry methods. These inaccuracies are exacerbated by common anesthetic medications.

Comparison of Temporal Artery Versus Rectal Temperature in Emergency Department Patients Who Are Unable to Participate in Oral Temperature Assessment.

INTRODUCTION: In the emergency department, pediatric and geriatric patients who present with illnesses and are unable to participate in oral evaluation of temperature must undergo a rectal temperature (RT) assessment. This study asks if a temporal artery temperature (TAT) measure can supplant the RT measure. METHODS: A convenience sample, using a within-subject design, was used to evaluate the efficacy of TAT compared with RT in patients ≤ 3 and ≥ 65 years of age, who were unable to participate in oral temperature assessments. RESULTS: Instrument reliability of the TAT is adequate for both the pediatric and geriatric populations. An unadjusted TAT did not provide acceptable temperature measurements. We also found that adjusting a TAT reading by adding -17.22°C (1° F) rendered the TAT average (either mean or median) adequately similar to RT averages for research purposes for both pediatric and geriatric groups. DISCUSSION: No influence was detected on the differences between RT and TAT due to age, sex, or emergency severity index (ESI) score in patients or due to profession, years of education, or years of experience in caregivers for either the pediatric or geriatric groups. Furthermore, the adjusted TAT reading could detect fever in individual patients adequately in both the pediatric and geriatric groups. However, the adjusted TAT readings were too frequently divergent from RT readings to be used to measure temperature in individual patients for both pediatric and geriatric groups.

Precision, Sensitivity and Patient Preference of Non-Invasive Thermometers in a Pediatric Surgical Acute Care Setting.

PURPOSE: The purpose of the project was to compare the temporal artery thermometer (TAT) to the digital probe thermometer readings at axillary or oral sites, to determine the relative precision and sensitivity of the three methods of thermometry, to compare their readings to core temperature when feasible, and to survey patient and family thermometer preferences. DESIGN & METHODS: A randomized crossover design in a 70-bed surgical unit over eight months. Two sets of temperature measurements were obtained for each patient: TAT, axillary, oral (depending on patient ability) and a bladder temperature representing core body temperature (when available). Each method was used twice on each patient, to examine within-method precision. Following measurement, patients or caregivers provided their thermometer preference. For younger/nonverbal patients, a professional observer recorded a disruption score. N=298 patients were enrolled RESULTS: TAT was more precise than oral and axillary thermometers (p<0.001 vs. axillary, p=0.001 vs. oral). TAT measurements were higher on average than axillary and oral, by 0.7°C and 0.6°C respectively (p<0.001). TAT's disruption score for younger patients was 0.6 points lower on average than axillary (p<0.001). 84% of patients and families who indicated a clear thermometry preference chose TAT. Only 3 patients had bladder-temperature devices, and therefore accuracy could not be analyzed. CONCLUSIONS: TAT is more precise, more fever sensitive, less disruptive to younger children, and more preferred by patients and families. PRACTICE IMPLICATIONS: TAT is an acceptable temperature measure that could be substituted for oral or axillary temperature in acute care pediatric settings.

Performance of infrared ear and forehead thermometers: a comparative study in 205 febrile and afebrile children.

AIMS AND OBJECTIVES: This study compared readings from two professional-grade, commercially available infrared (IR) thermometers, the ThermoScan® PRO 4000 prewarmed tip ear thermometer and the Temporal Scanner(™) TAT-5000 temporal artery thermometer. BACKGROUND: The repeatability and precision of readings from IR thermometers for professional use were questioned in the past, but in recent years, these types of thermometers have been technologically improved, so their ability to replicate standard temperature readings reliably should be re-examined. DESIGN: Febrile and afebrile children were recruited from the emergency department, overflow treatment areas and the paediatric intensive care unit of a large hospital in Argentina. Each child had a randomised sequence of seven temperature readings, including three from the ear, three from the forehead or behind the ear and one reference oral or rectal reading. METHODS: Temperature readings were taken with the ThermoScan PRO 4000, the Temporal Scanner TAT-5000 and the monitor mode of SureTemp® Plus, a widely used professional-grade contact thermometer, for reference. RESULTS: Of 205 children, 46% were febrile, per reference thermometer readings. While mean ThermoScan PRO 4000 febrile measurements did not differ significantly from reference, mean Temporal Scanner TAT-5000 febrile measurements were significantly lower (by a mean of 0·42 °C) than the reference. Overall bias of the ThermoScan PRO 4000 was significantly lower than that of the Temporal Scanner TAT-5000; repeatability was 1·5 times higher, and overall false-negative rate was about a third that of Temporal Scanner TAT-5000, when compared to the reference. CONCLUSIONS: This study indicates that the ThermoScan PRO 4000 provides measurements closer to those of a professional-grade contact thermometer when compared to the Temporal Scanner TAT-5000. RELEVANCE TO CLINICAL PRACTICE: The odds of misclassifying a febrile child as non-febrile were about threefold higher with the Temporal Scanner TAT-5000 temporal artery thermometer than with the ThermoScan® PRO 4000 ear thermometer.

Acceptance of temporal artery thermometry by Nigerian mothers: a comparison with the traditional methods.

INTRODUCTION: Temporal artery thermometry may be viewed as a suitable alternative to the traditional thermometry because of its safety and time efficiency. However, it is yet to gain wide acceptance in African settings because it is relatively new. The aim of this study was to compare the choices of Nigerian mothers between the traditional methods (axillary and rectal thermometry) and the temporal artery thermometry. METHODS: Rectal, axillary and forehead temperatures were measured in 113 children using rectal and axillary mercury in glass thermometers and infrared temporal artery thermometer respectively. The thermometry method preferred by each mother and the reason(s) were documented using a semi structured questionnaire. The data was analysed using SPSS version 19. RESULTS: The highest number of mothers 44(38.9%) preferred the axillary route while 42(37.2%) and 27(23.9%) preferred the temporal and rectal routes respectively. Temporal artery thermometry was the most popular among the mothers with tertiary education 27(39.7%), whereas axillary thermometry was most preferred among mothers with primary and secondary education, although this difference was not statistically significant (χ(2)=0.62,p = 0.96). Mothers 27(33.9%) who preferred rectal thermometry did so because they felt that since the thermometer is inserted inside the body, it will detect fever better. CONCLUSION: Nigerian mothers do not have any particular thermometry preference between the temporal artery thermometry and the traditional methods, so medical personnel in our environment may resort to any method that is convenient, accurate, fast and cost effective.