2.50
Hdl Handle:
http://hdl.handle.net/10755/162450
Type:
Presentation
Title:
Decision to Treat Febrile Pediatric ED Patients: Temporal Artery Thermometry
Abstract:
Decision to Treat Febrile Pediatric ED Patients: Temporal Artery Thermometry
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Waunch, Amy, RN, MSN, FNP, CEN
P.I. Institution Name:St. Joseph Hospital
Title:Advanced Practice Nurse
Contact Address:1100 W. Stewart Drive, Orange, CA, 92868, USA
Contact Telephone:714-771-8000
Co-Authors:Dana Rutledge, RN, PhD
[ENA Leadership Conference] Research Presentation: Decision to Treat Febrile Pediatric ED Patients: Temporal Artery Thermometry

Purpose: Standards of care related to thermometry in pediatric ED patients vary; no current method (rectal (R), oral (0), axillary (Ax), tympanic) offers totally acceptable precision and patient acceptability. No evidence was found pointing to cut-points for temporal artery (TA) readings for fever in children such as exist with O, R, and Ax readings. The study purpose was to determine if decisions to treat fever made using TA thermometry would be the same as those made using current hospital protocols for O/Ax temperature (children 5+ years) and R/Ax (under 5 years).

Design: Descriptive study.

Setting: 500+ bed Magnet community hospital ED.

Participants: Over a 2 year period, 90 ED patients age 0 to 17 years were recruited into the institutional review board-approved study. Children > 4 years had to be able to hold thermometers in their mouths for 1 minute. Excluded were children with conditions that precluded temperature measurement per protocol or with unstable conditions.

Methods: Temperature readings were taken using standard procedures by trained nurses using calibrated electronic thermometers (R, O, Ax) and new TA thermometers. Ax/O temperatures were taken, then TA and lastly, R; each was taken within 1 minute of the previous temperature.

Results: In the sample, 43 children were <5 years (56% female; mean age16 months) and 48 were between 5 and 17 (48% male; mean age 10 years). Most younger (63%) and 14% of older children had fever as chief complaint. The most common other complaint for younger children was upper respiratory infection; for older children, abdominal pain.

Fourteen younger children (33%) had a fever per R (>101 degrees F); only 6 of these children (15%) would have been considered febrile using Ax (>100.5 degrees F). None of the 14 febrile younger children had received antipyretics. Their TA temperatures ranged from 97.6 to 101.6 degrees F (X = 99.9, SD = 1.2). Using the R cutoff of 101 degrees F for fevers with TA readings, only 3 children would be declared febrile; using the Ax cutoff, 4 would be febrile.

Only one older child (2%) had a fever per O protocol (>101 degrees F) while 3 had fevers per Ax readings.

Implications: Given this data, it is apparent that TA readings in febrile children < 5 years (R) were widely variable. Congruence between R, Ax, and TA readings in these children was poor. No conclusions were drawn regarding older children due to low numbers. Based upon these findings, TA thermometry is not recommended for use in ED settings where pediatric patients are seen.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDecision to Treat Febrile Pediatric ED Patients: Temporal Artery Thermometryen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162450-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Decision to Treat Febrile Pediatric ED Patients: Temporal Artery Thermometry</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Waunch, Amy, RN, MSN, FNP, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Joseph Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Advanced Practice Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1100 W. Stewart Drive, Orange, CA, 92868, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">714-771-8000</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">amy.waunch@stjoe.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Dana Rutledge, RN, PhD</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Research Presentation: Decision to Treat Febrile Pediatric ED Patients: Temporal Artery Thermometry<br/><br/>Purpose: Standards of care related to thermometry in pediatric ED patients vary; no current method (rectal (R), oral (0), axillary (Ax), tympanic) offers totally acceptable precision and patient acceptability. No evidence was found pointing to cut-points for temporal artery (TA) readings for fever in children such as exist with O, R, and Ax readings. The study purpose was to determine if decisions to treat fever made using TA thermometry would be the same as those made using current hospital protocols for O/Ax temperature (children 5+ years) and R/Ax (under 5 years). <br/><br/>Design: Descriptive study.<br/><br/>Setting: 500+ bed Magnet community hospital ED.<br/><br/>Participants: Over a 2 year period, 90 ED patients age 0 to 17 years were recruited into the institutional review board-approved study. Children &gt; 4 years had to be able to hold thermometers in their mouths for 1 minute. Excluded were children with conditions that precluded temperature measurement per protocol or with unstable conditions.<br/><br/>Methods: Temperature readings were taken using standard procedures by trained nurses using calibrated electronic thermometers (R, O, Ax) and new TA thermometers. Ax/O temperatures were taken, then TA and lastly, R; each was taken within 1 minute of the previous temperature. <br/><br/>Results: In the sample, 43 children were &lt;5 years (56% female; mean age16 months) and 48 were between 5 and 17 (48% male; mean age 10 years). Most younger (63%) and 14% of older children had fever as chief complaint. The most common other complaint for younger children was upper respiratory infection; for older children, abdominal pain. <br/><br/>Fourteen younger children (33%) had a fever per R (&gt;101 degrees F); only 6 of these children (15%) would have been considered febrile using Ax (&gt;100.5 degrees F). None of the 14 febrile younger children had received antipyretics. Their TA temperatures ranged from 97.6 to 101.6 degrees F (X = 99.9, SD = 1.2). Using the R cutoff of 101 degrees F for fevers with TA readings, only 3 children would be declared febrile; using the Ax cutoff, 4 would be febrile.<br/><br/>Only one older child (2%) had a fever per O protocol (&gt;101 degrees F) while 3 had fevers per Ax readings.<br/><br/>Implications: Given this data, it is apparent that TA readings in febrile children &lt; 5 years (R) were widely variable. Congruence between R, Ax, and TA readings in these children was poor. No conclusions were drawn regarding older children due to low numbers. Based upon these findings, TA thermometry is not recommended for use in ED settings where pediatric patients are seen.</td></tr></table>en_GB
dc.date.available2011-10-27T10:28:25Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:25Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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