An evaluation of tympanic thermometry in a paediatric emergency department

Background and objectives: The consequences of missing fever in children can be grave. Body temperature is commonly recorded at the axilla but accuracy is a problem. This study aimed to evaluate the accuracy of a tympanic thermometer in the paediatric emergency setting. Method: In a total of 106 infants, the body temperature was measured in the daytime with an infrared tympanic thermometer, and at the axilla with an electronic thermometer and at the rectum (gold standard for measurement of body temperature). Fever was defined as a rectal temperature of 38.0 degrees C or greater, axillary temperature of 37.5 degrees C or greater, and tympanic temperature of 37.6 degrees C or greater. The temperature readings at the three sites were compared statistically. Results: There was a greater correlation of the tympanic measurement with the rectal measurement than the axillary with the rectal in both febrile and afebrile infants. The mean difference between the tympanic and rectal measurements was lower than that between the axillary and rectal measurements in both groups of infants (tympanic 0.38 degrees C and 0.42 degrees C, and axillary 1.11 degrees C and 1.58 degrees C, respectively). Tympanic measurements had a sensitivity of 76% whereas axillary measurements had a sensitivity of only 24% with rectal temperatures of 38-38.9 degrees C. Conclusion: Tympanic thermometry is more accurate than measurement of tempeature with an electronic axillary thermometer. It is also quick and safe, and thus it is recommended in the paediatric emergency setting.