Agreement Between Rectal and Tympanic Membrane Temperatures in Marathon Runners

Abstract

Study objective: To determine the agreement between rectal temperature and infrared tympanic membrane temperatures in marathon runners presenting to a field hospital at the finish line. Methods: The subjects of this prospective, blinded, controlled study were runners 18 years or older who were triaged to the acute care medical area at the finish line for suspected hypothermia, hyperthermia, dehydration, or altered mental status. Rectal and tympanic temperatures were measured simultaneously in all subjects for whom rectal temperature measurement had been deemed necessary and recorded on separate data cards. Results: Of the 239 runners treated in the acute care medical area, 37 required rectal temperature measurement and were enrolled in the study. The mean rectal temperature was 38.45º±1.20º C (range, 35.9º to 41.5º C). The mean tympanic membrane temperature was 37.81º±.95º C (range, 36.3º to 40.4º C). Pearson's correlation coefficient revealed a moderate correlation (r=.6902, P=.00023). The mean temperature difference between the two thermometers, mean rectal minus mean tympanic membrane, was .64º C (95% confidence interval, .35º to .93º C). Sixty-two percent of the tympanic membrane readings were within 1º C of their rectal counterparts. Agreement ranged from 1.16º (+2 SD) to -2.95º (-2 SD). The 95% confidence interval was 1.67º to -2.95º C. Conclusion: We were able to demonstrate only a moderate correlation between the two thermometer readings, with a wide spread between the limits of agreement. This spread could be clinically significant and therefore limits the usefulness of tympanic temperature in the marathon race setting. Because of the potentially large and clinically significant differences in rectal and tympanic temperatures and the limitations inherent in our study, we cannot endorse the use of tympanic temperature in the setting of a marathon event. [Roth RN, Verdile VP, Grollman LJ, Stone DA: Agreement between rectal and tympanic membrane temperatures in marathon runners. Ann Emerg Med October 1996;28:414-417.]