SCREENING FOR FEVER IN AN ADULT EMERGENCY DEPARTMENT - ORAL VS TYMPANIC THERMOMETRY

The accuracy of tympanic thermometers in clinical practice continues t o be questioned, We evaluated the Genius tympanic thermometer in our a dult emergency department. AU patients had both tympanic and oral temp erature measurements. Patients with an oral or tympanic temperature gr eater than or equal to 100.0 degrees F had a rectal temperature taken, Oral and rectal measurements were taken with the IVAC 2080A electroni c thermometer, and the Genins thermometer was used in the oral equival ent mode, All instruments were calibrated, Of the 332 patients entered into the study, 51 had oral or tympanic temperatures greater than or equal to 100.0 degrees F. Forty-one of these patients consented to a r ectal temperature measurement, The correlation (r) between tympanic an d oral, tympanic and rectal, and oral and rectal temperature was .845, .853, and .940, respectively, The oral thermometer identified all 28 febrile patients (rectal temperature greater than or equal to 100.4 de grees F), However, the tympanic thermometer detected fever in only 19 of these cases. Two patients in whom the tympanic thermometer failed t o detect fever had AIDS, and their workup was altered by the detection of the fever. We conclude that the tympanic thermometer is not as sen sitive as the oral thermometer in the detection of fever, The use of t ympanic thermometers in the adult emergency department should be quest ioned.