THE PACIFIER THERMOMETER - COMPARISON OF SUPRALINGUAL WITH RECTAL TEMPERATURES IN INFANTS AND YOUNG-CHILDREN

Objective: To determine the correlation between supralingual temperatu res obtained with a new electronic pacifier thermometer (Steridyne) an d rectal temperatures obtained with a digital electronic thermometer. Design: Prospective study. Setting: Pediatric emergency department and pediatric inpatient ward of a tertiary university hospital. Participa nts: Convenience sample of 100 patients, aged 7 days to 24 months. Mai n Outcome Measures: A supralingual and rectal temperature were obtaine d for each patient. For the first 30 patients, the time needed for the pacifier thermometer to signal a final, steady-state reading was reco rded. Results: The mean+/-SD difference between rectal temperatures an d supralingual temperatures adjusted upward by 0.5 degrees F was -0.01 degrees F+/-0.42 degrees F (statistically zero) (95% confidence inter val, -0.09 degrees F to 0.07 degrees F). The correlation coefficient b etween supralingual and rectal temperatures was 0.95. Sensitivity and specificity of the pacifier thermometer for detecting fever (temperatu re greater than or equal to 100.4 degrees F [greater than or equal to 38.0 degrees C]) was 72.0% and 98.0%, respectively (positive predictiv e value, 97.3%; negative predictive value, 77.8%). Increasing supralin gual temperatures by 0.5 degrees F increased sensitivity to 92.0%, and decreased specificity to 76.0% (positive predictive value, 79.3%; neg ative predictive value, 90.5%). It took an average time of 3 minutes 2 3 seconds for the pacifier thermometer to display a steady-state tempe rature. Conclusions: The pacifier thermometer evaluated here was found to be an accurate means of temperature measurement when recorded temp eratures were adjusted upward by 0.5 degrees F. The approximate 3 minu tes required for a final temperature determination makes the pacifier thermometer most appropriate for use in low-volume ambulatory care set tings and in the home. Further investigation of this device is recomme nded.