USE OF TYMPANIC THERMOMETERS TO SCREEN FOR FEVER IN PATIENTS IN A PEDIATRIC EMERGENCY DEPARTMENT

The use of tympanic thermometers has markedly increased over the past few years. While some authors have shown high correlation between rect al and tympanic readings, others have found low correlation. After not icing a failure of the tympanic thermometer to detect fever in obvious ly febrile pediatric patients, we prospectively evaluated its use in o ur emergency department. All patients less than 6 years of age who wer e brought in for care over a 2-week period were eligible for entry int o the study. Nurses were trained in the proper use of the instruments before the study began. We used a calibrated tympanic thermometer (Fir st Temp 2000A) and an electronic thermometer (IVAC 2080A). In all chil dren the tympanic temperature was measured first, immediately followed by measurement of the rectal temperature. The 39 children entered int o the study ranged in age from 2 to 71 months (mean of 27 months). Rec tal temperature ranged from 97.8-degrees to 105.2-degrees-F. The corre lation between rectal and tympanic was low (r = .830) and was worse in patients with fever (r = .612). The mean difference was 0.8-degrees-F , but was as high as 3.4-degrees-F. The tympanic thermometer failed to identify five of the 15 febrile patients (T greater-than-or-equal-to 100.5-degrees-F) in our study. We therefore conclude that the tympanic thermometer is not sensitive enough to be used to screen for fever in pediatric patients.