Can Temporal Artery Replace Rectal Temperatures in Pediatric Emergency Department Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/198355
Title:
Can Temporal Artery Replace Rectal Temperatures in Pediatric Emergency Department Patients
Abstract:
[ENA Annual Conference 2011 - Research Presentation] Can Temporal Artery Replace Rectal Temperatures in Pediatric ED Patients?
Pacific Northwest Region

Purpose: Safe and accurate temperature measurement in most emergency departments (ED) requires that children under the age of 4 receive rectal temperatures measurement. A new temperature measurement device, the temporal artery thermometer, could potentially replace the need for rectal temperatures in young children if it can be shown to be accurate. The purpose of this study was to determine the accuracy of temporal artery thermometers in pediatric ED patients.

Design: A method-comparison study design was used to examine the agreement between a temporal artery thermometer and a non-disposable, rectal electronic thermometer, the clinical reference standard for temperature measurement in children.

Setting: ED of a not-for-profit, community-based hospital in the Pacific Northwest, with 69,000 ED visits / year. Not trauma certified.

Participants / Subjects: Participants were a convenience sample of pediatric patients admitted to the emergency department. Inclusion criteria included age < four years and presentation in the ED triage area. Exclusion criteria included unstable patients classified as emergent or very urgent; injury or body deformity at the site for temperature measurements; and/or behavior disturbance observed or diagnosed that might cause participation in the study to be upsetting to the child. A sample size was determined a priori based on power analysis. The study was approved by the institution’s investigational review board and parental consent obtained prior to study enrollment.

Methods: Temperatures were taken once with each device in the ED triage area by a study investigator. Bias and precision were calculated to quantify the differences between the two devices, with data graphed in the Bland-Altman method. Percent of disposable electronic temperatures which were > 0.5, 1.0, and 1.5 degrees C higher or lower than the clinical reference temperatures were also calculated. All temperatures were obtained according to manufacturers’ directions with equipment that was calibrated by biomedical engineering prior to dedicated use for the study. Rectal temperatures were measured with an electronic thermometer (Sure Temp Plus 690, Welch Allyn, Skaneateles Falls, NY). Temporal artery temperatures were measured with an infrared thermometer (TAT 5000, Exergen Corp, Watertown, MA).

Results: A total of 52 pediatric ED patients were studied over a 10 month period. Temperatures ranged from 36.6 to 40.1 degrees C, averaging (± SD) 37.8 ± 0.8 degrees C. Bias and precision for the temporal artery device was 0.46 ± 0.59 degrees C. The number of temperatures measured with the temporal artery thermometer that were > 0.5, > 1.0, and/or > 1.5 degrees C above or below the clinical reference temperatures were 21 (40%), 8 (15%), and 3 (6%), respectively.

Conclusions: This study found that the accuracy of the temporal artery device minimally achieved the level recommended by experts to serve as a substitute for core body temperature measurements. One out of 6 temporal artery temperatures were > ± 1.0 degrees different from rectal temperatures. While accurate enough for routine temperature measurement in pediatric ED patients, the temporal artery thermometer may not be appropriate for clinical situations where precise core temperature determination is essential.


Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleCan Temporal Artery Replace Rectal Temperatures in Pediatric Emergency Department Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198355-
dc.description.abstract[ENA Annual Conference 2011 - Research Presentation] Can Temporal Artery Replace Rectal Temperatures in Pediatric ED Patients?<br/>Pacific Northwest Region<br/><br/>Purpose: Safe and accurate temperature measurement in most emergency departments (ED) requires that children under the age of 4 receive rectal temperatures measurement. A new temperature measurement device, the temporal artery thermometer, could potentially replace the need for rectal temperatures in young children if it can be shown to be accurate. The purpose of this study was to determine the accuracy of temporal artery thermometers in pediatric ED patients.<br/><br/>Design: A method-comparison study design was used to examine the agreement between a temporal artery thermometer and a non-disposable, rectal electronic thermometer, the clinical reference standard for temperature measurement in children.<br/><br/>Setting: ED of a not-for-profit, community-based hospital in the Pacific Northwest, with 69,000 ED visits / year. Not trauma certified.<br/><br/>Participants / Subjects: Participants were a convenience sample of pediatric patients admitted to the emergency department. Inclusion criteria included age < four years and presentation in the ED triage area. Exclusion criteria included unstable patients classified as emergent or very urgent; injury or body deformity at the site for temperature measurements; and/or behavior disturbance observed or diagnosed that might cause participation in the study to be upsetting to the child. A sample size was determined a priori based on power analysis. The study was approved by the institution’s investigational review board and parental consent obtained prior to study enrollment.<br/><br/>Methods: Temperatures were taken once with each device in the ED triage area by a study investigator. Bias and precision were calculated to quantify the differences between the two devices, with data graphed in the Bland-Altman method. Percent of disposable electronic temperatures which were > 0.5, 1.0, and 1.5 degrees C higher or lower than the clinical reference temperatures were also calculated. All temperatures were obtained according to manufacturers’ directions with equipment that was calibrated by biomedical engineering prior to dedicated use for the study. Rectal temperatures were measured with an electronic thermometer (Sure Temp Plus 690, Welch Allyn, Skaneateles Falls, NY). Temporal artery temperatures were measured with an infrared thermometer (TAT 5000, Exergen Corp, Watertown, MA).<br/><br/>Results: A total of 52 pediatric ED patients were studied over a 10 month period. Temperatures ranged from 36.6 to 40.1 degrees C, averaging (± SD) 37.8 ± 0.8 degrees C. Bias and precision for the temporal artery device was 0.46 ± 0.59 degrees C. The number of temperatures measured with the temporal artery thermometer that were > 0.5, > 1.0, and/or > 1.5 degrees C above or below the clinical reference temperatures were 21 (40%), 8 (15%), and 3 (6%), respectively. <br/><br/>Conclusions: This study found that the accuracy of the temporal artery device minimally achieved the level recommended by experts to serve as a substitute for core body temperature measurements. One out of 6 temporal artery temperatures were > ± 1.0 degrees different from rectal temperatures. While accurate enough for routine temperature measurement in pediatric ED patients, the temporal artery thermometer may not be appropriate for clinical situations where precise core temperature determination is essential.<br/> <br/><br/>en_GB
dc.date.available2011-12-21T12:47:09Z-
dc.date.issued2011-12-21T12:47:09Z-
dc.date.accessioned2011-12-21T12:47:09Z-
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