ACCURACY OF INFRARED EAR THERMOMETRY AND TRADITIONAL TEMPERATURE METHODS IN YOUNG-CHILDREN

Objective: To compare the accuracy of ear-based, rectal, and axillary temperature measurements in comparison to bladder temperature as a cor e reference. Design: Repeated-measures comparison study. Settings: Ped iatric critical care settings in two tertiary care hospitals. Patients : Thirty children, 1 to 45 months old (mean 16.6 months), who required bladder catheters for their care. Outcome Measures: Correlation and a greement (mean offset +/- SD) of ear-based, rectal, and axillary tempe rature measurements with bladder temperature. Procedure: Ear-based mea surements were made with three infrared thermometers in the core mode, both with and without an ear tug. All six readings were made in the s ame ear in randomized order. Bladder, rectal, and axillary temperature s were read from continuous digital displays immediately after each ea r-based measurement. Results: Ear-based readings correlated relatively well with bladder temperature (r = 0.80 to 0.87), but were lower by m eans of -0.3-degrees to -0.7-degrees-C with moderately high variation (SD = 0.4-degrees to 0.5-degrees-C) between children. Use of an ear tu g did not affect the readings. Rectal temperature correlated well with bladder values (r = 0,93 to 0.97) and was usually slightly higher (me an offset = 0.2 +/- 0.2 [SD]-degrees-C), while axillary temperature co rrelated rather poorly (r = 0.59 to 0.64), with much lower and more va riable readings (mean offset = -0.9-degrees +/- 0.6-degrees-C). In reg ard to sensitivity, specificity, and predictive value in screening for fever, rectal readings performed very well, ear-based readings modera tely well with some variation, and axillary readings poorly. Conclusio ns: The findings suggest that the additive core-mode adjustments in in frared ear thermometers are too low for young children, an ear tug is not an essential part of measurement technique, rectal temperature clo sely reflects bladder temperature, and axillary temperature is low and highly variable.