Tympanic Temperature Measurements Research Articles

Evaluating the Agreement between Oral, Armpit, and Ear Temperature Readings during Physical Activities in an Outdoor Setting.

Accurate body temperature measurement is essential for monitoring and managing safety during outdoor activities. Physical activities are an essential consideration for public health, with sports taking up an important proportion of these. Athletes' performances can be directly affected by body temperature fluctuations, with overheating or hypothermia posing serious health risks. Monitoring these temperatures allows coaches and medical staff to make decisions that enhance performance and safety. Traditional methods, like oral, axillary, and tympanic readings, are widely used, but face challenges during intense physical activities in real-world environments. This study evaluated the agreement, correlation, and interchangeability of oral, axillary, and tympanic temperature measurements in outdoor exercise conditions. Systems developed for specific placements might generate different sensor readouts. Conducted as an observational field study, it involved 21 adult participants (11 males and 10 females, average age 25.14 ± 5.80 years) that underwent the Yo-Yo intermittent recovery test protocol on an outdoor court. The main outcomes measured were the agreement and correlation between temperature readings from the three methods, both before and after exercise. The results indicate poor agreement between the measurement sites, with significant deviations observed post-exercise. Although the Spearman correlation coefficients showed consistent temperature changes post-exercise across all methods, the standard deviations in the pairwise comparisons exceeded 0.67 °C. This study concluded that widely used temperature measurement methods are challenging to use during outdoor exercises and should not be considered interchangeable. This variability, especially after exercise, underscores the need for further research using gold standard temperature measurement methods to determine the most suitable site for accurate readings. Care should thus be taken when temperature screening is done at scale using traditional methods, as each measurement site should be considered within its own right.

Agreement of zero-heat-flux thermometry with the oesophageal and tympanic core temperature measurement in patient receiving major surgery.

To identify and prevent perioperative hypothermia, most surgical patients require a non-invasive, accurate, convenient, and continuous core temperature method, especially for patients undergoing major surgery. This study validated the precision and accuracy of a cutaneous zero-heat-flux thermometer and its performance in detecting intraoperative hypothermia. Adults undergoing major non-cardiac surgeries with general anaesthesia were enrolled in the study. Core temperatures were measured with a zero-heat-flux thermometer, infrared tympanic membrane thermometer, and oesophagal monitoring at 15-minute intervals. Taking the average value of temperature measured in the tympanic membrane and oesophagus as a reference, we assessed the agreement using the Bland-Altman analysis and linear regression methods. Sensitivity, specificity, and predictive values of detecting hypothermia were estimated. 103 patients and one thousand sixty-eight sets of paired temperatures were analyzed. The mean difference between zero-heat-flux and the referenced measurements was -0.03 ± 0.25°C, with 95% limits of agreement (-0.52°C, 0.47°C) was narrow, with 94.5% of the differences within 0.5°C. Lin's concordance correlation coefficient was 0.90 (95%CI 0.89-0.92). The zero-heat-flux thermometry detected hypothermia with a sensitivity of 82% and a specificity of 90%. The zero-heat-flux thermometer is in good agreement with the reference core temperature based on tympanic and oesophagal temperature monitoring in patients undergoing major surgeries, and appears high performance in detecting hypothermia.

Infrared Imaging of the Brain-Eyelid Thermal Tunnel: A Promising Method for Measuring Body Temperature in Afebrile Children.

(1) Infrared thermography of the inner canthus of the eye has emerged as a promising tool for temperature screening and fever diagnosis. Its non-invasive nature lends itself well to mass screening in diverse settings such as schools, public transport, and healthcare facilities. Swift and accurate temperature assessment plays a pivotal role in the early identification of potential fever cases, facilitating timely isolation, testing, and treatment, thereby mitigating the risk of disease transmission. Nonetheless, the reliability of this approach in the pediatric population, especially when compared to conventional thermometry methods, remains unexplored. This preliminary study aimed to evaluate the concordance between the temperature of the inner canthus of the eye (Tic,eye), referred to as the brain-eyelid thermal tunnel (BTT°), with axillary and tympanic methods in afebrile children. (2) Methods: A cohort of 36 children, matched in a 1:1 ratio for gender and age, underwent comprehensive assessments encompassing anthropometric data, blood pressure evaluations, axillary (Tax) and tympanic (Tty) temperature measurements, as well as BTT° infrared thermography. (3) Results: The findings revealed a high level of concordance among the tympanic, axillary, and BTT° measurement methods. Bland-Altman plots showed that the bias was minimal, and no statistically significant differences were observed when comparing BTT° with axillary (p = 0.136) and tympanic (p = 0.268) measurements. Passing-Bablok regression scatter plots further confirmed the agreement, aligning the fitted regression line closely with the identity line for both axillary versus BTT° and tympanic (Tty) versus BTT° comparisons. (4) Conclusions: This study holds significant implications for public health, especially in the context of infectious disease outbreaks such as COVID-19. BTT° infrared thermography of the inner canthus of the eye (Tic,eye) reliably measures body temperature in afebrile children in controlled settings; nevertheless, its practical application necessitates the adaptation of biothermodynamic parameters to accommodate diverse environmental conditions.

Detection of Fever Using Continuous Skin Temperature Monitoring in Hospitalized Older Adults

The continuous monitoring of body surface temperature has been proven to help detect potential fever events in hospitalized patients. However, the efficacy of using body surface temperature to detect fever in older adults remains unclear due to the relatively low and slower-to-change body surface temperature in this population. This study was designed to investigate 1) the relationship between changes in body surface and routine tympanic temperatures, 2) the correlation between body surface temperature measurement frequency and detection of fever, and 3) the factors related to the incidence of fever in hospitalized older adults. A prospective study was conducted on 33 hospitalized older adults aged 65 years or older who were suspected to have or diagnosed with an infection in an infectious disease and medical ward at a medical center in southern Taiwan from March to November 2020. Demographic, routine tympanic temperature, and heart rate data were collected by reviewing the participants' medical records. Body surface temperatures were monitored continuously using HEARThermo every 10 seconds until one of the following conditions were met: hospital discharge, no fever for three continuous days, and HEARThermo was removed. Descriptive analysis was used to compare the variations in body surface temperature and routine tympanic temperature measurements. Pearson correlation was used to analyze the correlation between different measurement frequencies and fever events. Finally, mixed effects logistic regression was used to analyze the factors significantly related to fever events. Seven hundred and twenty routine body temperature measurements were taken, with 209 (29.0%) fever events detected in 23 (69.7%) of the participants. The body surface temperatures were more closely correlated with tympanic temperatures during fever events than non-fever events (r = .260, p < .001). More fever events were detected using body surface temperature monitoring frequencies of every 10 seconds and every 1 minute. After controlling for demographic factors, the results of the mixed effect model indicate that body surface temperature and heart rate are significant factors related to fever events in hospitalized older adults (odds ratio, OR: 1.74, p < .001; OR: 1.11, p < .001). The continuous monitoring of body surface temperature may improve the detection of fever events in hospitalized older adults. The application of wearable devices and cloud platforms may further facilitate the real-time assessment and care capabilities of nurses, thus reducing their workload and improving care quality.

Exertional Heatstroke Support at the Acute Phase: Assessment of Professional Practices in the French Military Forces.

Exertional heatstroke (EHS) is defined as a disturbance in consciousness, ranging from confusion to coma, with hyperthermia typically higher than 40 °C that occurs during intense physical activity. It is a life-threatening pathology that has been observed in the military since antiquity. Recent research has changed the understanding of the pathophysiology of EHS and led to the development of gold-standard treatment, which includes intrarectal temperature monitoring and cooling the patient as quickly as possible. The objective of this study was to describe the theoretical knowledge of French military unit practitioners regarding the latest recommendations for the treatment of EHS and their management of this condition in practice. We conducted a web-based survey from August 2 to December 31, 2020, including all French military practitioners. The questionnaire, sent via email, aimed to describe practitioners' theoretical knowledge of EHS and its practical management. Practitioners who had a local management protocol were asked to include it with their responses to analyze and determine if protocols complied with the latest recommendations. The responses were collected by name, anonymized, and analyzed by a single investigator. This observational study was exempted from ethics board approval by the French Military Health Service's research department. Of the questionnaires sent, 84 practitioners responded, describing their theoretical knowledge of EHS. Of the respondents, 42 had experience managing EHS and described their practical management of EHS in the field. In addition, 15 local protocols were analyzed. Intrarectal temperature measurement was recommended by 71 physicians (84.5%), and cooling was preferably achieved by immersion in cold water by 65 practitioners (77.4%). If this method was unavailable, only 36.9% (24/65) of practitioners submerged patients in water at room temperature. Nine practitioners (10.7%) had perfect theoretical knowledge, and 36 (42.9%) knew the optimal management of EHS. There was no difference in the frequency of perfect theoretical knowledge between practitioners who had experience with EHS (9/36) and those who did not (12/48; P = 1). Practitioners who had experience with EHS had better optimal management knowledge than those who did not (61.1% vs.29.1%; P = .03). In practice, 21 (50%) cases had intrarectal temperature monitoring, and only 6 (14.3%) were immersed in cold water. Logistical challenges prevented optimal cooling methods in 29 (90.6%) cases. Concerning the other aspects of management, four (26.7%) practitioners recommended tympanic temperature measurement, two (20%) did not indicate immersion for cooling, and one (6.7%) administered paracetamol. French military practitioners' theoretical knowledge of EHS is insufficient for a lethal pathology that is common in the military. Thus, improvements must be made in training and disseminating up-to-date knowledge. In practice, a lack of adequate logistics and the fact that first responders are rarely practitioners increase the suboptimal care of EHS. First responders should be equipped with valid and adapted protocols and adequate logistical means to manage this condition. By establishing a cohort of well-treated patients, we will be able to develop evidence-based recommendations for when to cease cooling and identify intrinsic susceptibility to EHS.

Incidence of inadvertent perioperative hypothermia in pediatric laparoscopic surgery: a prospective observational single-center study.

Abstract&#x0D; Objective&#x0D; The pediatric age group is in the risk group for Inadvertent perioperative hypothermia (IPH) due to insufficient subcutaneous adipose tissue and underdeveloped thermoregulatory responses.&#x0D; We aimed to determine the frequency of IPH in the pediatric age group undergoing laparoscopic surgery.&#x0D; Methods&#x0D; The study is prospective observational.&#x0D; Pediatric patients (1-18 years old) who underwent laparoscopic surgery under general anaesthesia were evelueted. The tympanic membrane temperature measurements of the patients (°C) were recorded before anaesthesia induction (T0) and then every 15 minutes during the surgery.&#x0D; Results&#x0D; A total of 100 patients were evaluated. The frequency of inadvertent perioperative hypothermia was detected 13 (13%). Frequency of IPH on elective surgery patients was higher than emergency surgery (

Effect of Upper Limb Warming Blanket on Body Temperature Control During Total Hip Arthroplasty and Total Knee Arthroplasty

Background: At our research facility, the body temperature is constantly monitored using a continuous-measuring ear thermometer, i.e., Nipro CE Thermo (hereafter CE Thermo). However, this temperature control assumes that the CE Thermo itself does not get affected, thus warranting the identification of influencing factors for temperature control based on their influence on the CE Thermo. We aimed to evaluate the tympanic membrane temperature of patients undergoing lower limb surgery under general anesthesia, and to explore body temperature fluctuations during anesthesia based on the tympanic membrane temperature. Methods: We selected patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) for lower extremities at the Department of Orthopedic Surgery, Okinawa Tokushukai Kamagaya General Hospital between January 2017 and March 2020. We conducted a retrospective observational study of 173 patients undergoing THA and TKA for lower extremities at a single institution. Results: We calculated and compared the tympanic temperature measurements at 5, 10, 15, 20, 25, 30, 35, and 40 min between the groups to predict the factors of temperature variation. The results of tympanic temperature measurements were analyzed using two-way analysis of variance. At the beginning of the measurement, the THA group demonstrated significantly lower values than the TKA group (P = 0.001). Conclusions: The above results necessitate further clarification of the effect of temperature fluctuation, including surgical factors, on prognosis. J Curr Surg. 2022;12(1):7-14 doi: https://doi.org/10.14740/jcs456

Axillary temperature measurements based on smart wearable thermometers in South Korean children: comparison with tympanic temperature measurements.

PurposeThis study explored the validity of a new type of thermometer and parent satisfaction with the new device. This 24-hour continuous monitoring smart wearable wireless thermometer (TempTraq®) uses a very small semiconductor sensor with a thin patch-like shape.MethodsWe obtained 397 sets of TempTraq® axillary temperatures and tympanic temperatures from 44 pediatric patients. Agreement between the axillary and tympanic measurements, as well as the validity of the TempTraq® axillary temperatures, were evaluated. Satisfaction surveys were completed by 41 caregivers after the measurements.ResultsThe TempTraq® axillary temperatures demonstrated a strong positive correlation with the tympanic temperatures. The Bland-Altman plot and analysis of TempTraq® axillary temperatures and tympanic temperatures showed that the mean difference was +0.45 ℃, the 95% limits of agreement were -0.57 to +1.46 ℃. Based on a tympanic temperature of 38 ℃, the results of validity of fever detection were sensitivity 0.85 and specificity 0.86. Satisfaction scores for TempTraq® temperature measurement were all > 4 points (satisfactory).ConclusionTempTraq® smart axillary temperature measurement is an appropriate method for measuring children's temperatures since it was highly correlated to tympanic temperatures, had a reliable level of sensitivity and specificity, and could be used safely and conveniently.

Clinical accuracy and agreement between tympanic and forehead body temperature measurements for screening of patients with COVID‐19

To investigate the accuracy, reliability and agreement between infrared forehead thermometers versus infrared tympanic thermometers temperature, a cross-sectional study was conducted in April 2020. The forehead and tympanic temperatures of 615subjects were measured simultaneously in three exposed SARS-COV-2groups at one hospital in Iran, during April 2020. These comparisons were evaluated by Bland-Altman Plot, repeatability, Passing-Bablok regression and Lin's concordance correlation coefficient. The receiver operating characteristic (ROC) analysis was done to describe the discrimination accuracy of a diagnostic test. The study adhered to STROBE checklist for cross-sectional studies. A Bland-Altman plot indicated that the limits of agreement between the forehead and tympanic temperature were -0.259 to +0.19°C. Passing-Bablok regression analysis illustrated that the infrared forehead was not linearly related to tympanic temperatures (reference method), with a slope estimate that was significantly different from 1.00. The infrared forehead thermometer showed poor precision and lower accuracy than the tympanic. The forehead temperature readings had 60.0% sensitivity and 44.4% specificity (p>.05) to predict disease. According to the results of study, there is no evidence that the assessment of temperature by infrared forehead thermometer could discriminate between the two groups (positive and negative).

The Effect of Ear Drainage and Middle Ear Inflammation due to Chronic Otitis Media on Infrared Tympanic Temperature Measurement

The Effect of Ear Drainage and Middle Ear Inflammation due to Chronic Otitis Media on Infrared Tympanic Temperature Measurement

99 Heritability of Temperature and the Effects of Ageing on Temperature Regulation: An Observational Multi-Cohort Study

IntroductionAgeing affects homeostasis and immunosenescence, resulting in aberrant fever and immune responses to infection in older adults. This study assesses heritability of basal temperature and explores effects of ageing on basal temperature and temperature in response to SARS-CoV-2 infection.MethodsObservational study using multiple cohorts. Participants: (a) Twin volunteers: 1089 healthy adults enrolled in Twins-UK, mean age 59 (17); tympanic temperature measurements; (b) Community-based: 3972 adults using the COVID Symptom Study mobile application, age 43 (13); self-reported test-positive for SARS-CoV-2 infection; self-reported temperature measurements; (c) Hospitalised: cohorts of 520 and 757 adult patients with emergency admission to two teaching hospitals between 01/03/2020–04/05/2020, age 62 (17) and 68 (17) respectively; RT-PCR-confirmed SARS-CoV-2 infection.Analysis(a) heritability analysed using saturated and ACE univariate models; linear mixed-effect model for associations between basal temperature and age, sex and BMI. (b&c) multivariable linear regression for associations between temperature and age, sex and BMI; multivariable logistic regression for associations between fever(>/= 37.8°C) and age, sex and BMI.ResultsBasal temperature in twins demonstrated 50% heritability (95%CI[42–57%]). In healthy twin, community-based and hospitalised cohorts, increasing age is associated with lower temperatures, and increasing BMI with higher temperatures: (a) Twins (age:p < 0.001; BMI:p = 0.002); (b) Community-based (age: p < 0.001; BMI: p < 0.001); (c) Hospitalised (1st hospital: age: p = 0.106; BMI: p = 0.033; 2nd hospital: age: p < 0.001; BMI: p = 0.010). Increasing age was negatively and BMI positively associated with fever (1st hospital: Age: OR = 0.99, p = 0.033; BMI: OR = 1.00, p = 0.045; 2nd hospital: Age: OR = 0.99, p = 0.010; BMI: OR 1.02, p = 0.038).ConclusionsHeritability of basal temperature suggests a genetic component to thermoregulation. Associations observed between increasing age and lower temperatures and higher BMI and higher temperatures are important in understanding effects of ageing and obesity on basal temperature and the fever response. In older adults, findings have important implications for defining fever thresholds and diagnosing infections, including SARS-CoV-2.

Comparison of Tympanic and Tail Temperatures in Angus and Brahman Steers

In cattle, core body temperature can be used as an important indicator of heat stress level. However, accurately recording core body temperature can be difficult and labor intensive. The objectives of the current study were 1) to compare the recorded tympanic and tail body temperature measurements in steers and 2) to determine the body temperature change of Angus and Brahman steers in a hot and humid environment. Data was analyzed using a repeated measure model where repeated measures were hourly tympanic and tail temperatures and their difference for individual steers during the day of the experiment. There was a significant breed effect (P=0.01), hour (P&lt;0.0001) and breed by hour interaction (P&lt;0.0001) for the tympanic temperature. Brahman steers, which are known to have superior thermotolerance, maintained a lower body temperature than the Angus steers during the afternoon under grazing conditions. In the Brahman steers there was only a minimal increase in the body temperature throughout the day, an evidence of the thermotolerance ability of the breed. In the Angus steers, which experienced an increase in their body temperature from hour to hour with a peak around 1600 hour; there was a significant difference between the tympanic and tail temperature during the times when the body temperature as measured by the tympanic recordings was the highest (1300 to 1700 hour). Our results indicate that the tympanic temperature can be used to accurately and continuously monitor core body temperature in a natural environment for up to several days and without disturbing the animal.

Does magnetic resonance imaging increase core body temperature in children? Results of the administration of propofol and ketofol: a randomized clinical study.

Magnetic resonance imaging (MRI) may cause a temperature increase in the imaging area, while intravenous anesthetics may develop a tendency for hypothermia, especially in the pediatric population. The effect of different anesthetics on core body temperature in children during these procedures remains controversial. We examined the effect of propofol and ketofol on core body temperatures in a pediatric population during MRI. Our hypothesis was that the increase in body temperature will be more prominent in pediatric patients receiving ketofol than in those receiving propofol. This was a randomized, prospective, double-blind study in pediatric patients aged 6 months to 10 years. The patients were American Society of Anesthesiologist (ASA) physical class I-II who had undergone MRI under anesthesia at the Cerrahpasa School of Medicine, MRI Area, between August 2014 and February 2016. Patients were assigned to one of two groups: Group I (propofol group) and Group II (ketofol group). MRIs were performed with a 1.5 Tesla (T) device. Bilateral tympanic membrane temperature measurements before and after the procedure were performed. Body temperature decreased in both groups after MRI. Clinically significant hypothermia or hyperthermia was not observed in any of the patients. Temperature monitoring is not necessary for every patient being imaged. However, temperature changes should be closely monitored in high-risk patients.

Os efeitos do aquecimento de cristaloides sobre a temperatura corporal materna e nas condições fetais: ensaio clínico randômico

Background and objectivesHypothermia occurs in about 60% of patients under anesthesia and is generally not managed properly during short lasting surgical procedures. Hypothermia is associated with adverse clinical outcomes. The current study is designed to assess the effects of crystalloid warming on maternal and fetal outcomes in patients undergoing elective cesarean section with spinal anesthesia. MethodsIn this prospective randomized controlled trial, sixty parturients scheduled for elective cesarean section with spinal anesthesia were randomly allocated to receive crystalloid at room temperature or warmed at 37°C. Spinal anesthesia was performed at L3–L4 interspace with 10mg of hyperbaric bupivacaine without adding opioids. Core temperature, shivering, and hemodynamic parameters were measured every minute until 10th minute and 5‐min intervals until the end of operation. The primary outcome was maternal core temperature at the end of cesarean section. ResultsThere was no difference for baseline tympanic temperature measurements but the difference was significant at the end of the operation (p=0.004). Core temperature was 36.8±0.5°C at baseline and decreased to 36.3±0.5°C for isothermic warmed crystalloid group and baseline tympanic core temperature was 36.9±0.4°C and decreased to 35.8±0.7°C for room temperature group at the end of the operation. Shivering was observed in 43.3% in the control group. Hemodynamic parameter changes and demographic data were not significant between groups. ConclusionsIsothermic warming crystalloid prevents the decrease in core temperature during cesarean section with spinal anesthesia in full‐term parturients. Fetal Apgar scores at first and fifth minute are higher with isothermic warming.

The effects of crystalloid warming on maternal body temperature and fetal outcomes: a randomized controlled trial

Background and objectivesHypothermia occurs in about 60% of patients under anesthesia and is generally not managed properly during short lasting surgical procedures. Hypothermia is associated with adverse clinical outcomes. The current study is designed to assess the effects of crystalloid warming on maternal and fetal outcomes in patients undergoing elective cesarean section with spinal anesthesia. MethodsIn this prospective randomized controlled trial, sixty parturients scheduled for elective cesarean section with spinal anesthesia were randomly allocated to receive crystalloid at room temperature or warmed at 37°C. Spinal anesthesia was performed at L3–L4 interspace with 10mg of hyperbaric bupivacaine without adding opioids. Core temperature, shivering, and hemodynamic parameters were measured every minute until 10th minute and 5-min intervals until the end of operation. The primary outcome was maternal core temperature at the end of cesarean section. ResultsThere was no difference for baseline tympanic temperature measurements but the difference was significant at the end of the operation (p=0.004). Core temperature was 36.8±0.5°C at baseline and decreased to 36.3±0.5°C for isothermic warmed crystalloid group and baseline tympanic core temperature was 36.9±0.4°C and decreased to 35.8±0.7°C for room temperature group at the end of the operation. Shivering was observed in 43.3% in the control group. Hemodynamic parameter changes and demographic data were not significant between groups. ConclusionsIsothermic warming crystalloid prevents the decrease in core temperature during cesarean section with spinal anesthesia in full-term parturients. Fetal Apgar scores at first and fifth minute are higher with isothermic warming.

Axillary and Tympanic Temperature Measurement in Children and Normal Values for Ages.

The aim of the study was define the normal values of tympanic and axillary body temperature in healthy children. This observational cross-sectional study was performed in healthy children aged 0 to 17 years who visited the ambulatory general pediatric of Istanbul Medical Faculty. Of 1364 children, 651 (47.7%) were girls and 713 were boys, the mean (SD, range) age was 72.5 (53.6, 1-204) months. The mean (SD) axillary body temperature was 36.04°C (0.46°C; minimum, 35.0°C; maximum, 37.6°C). The 95th and 99th percentiles were 36.8°C and 37.0°C, respectively. The mean (SD) tympanic body temperature was 36.91°C (0.46°C; minimum, 35.15°C; maximum, 37.9°C). The 95th and 99th percentiles were 37.6°C and 37.8°C, respectively. There were statistically significant differences between sexes for only tympanic body temperatures. Both axillary and tympanic body temperatures were statistically higher in 0 to 2 months compared with other age groups. For this age group, the 99th percentile was 37.5°C for axillary and 37.85°C for tympanic temperature. Axillary and tympanic body temperatures should be considered as fever when they are more than 37.0°C and 37.8°C, respectively. For 0 to 2 months, fever is 37.5°C and 37.85°C in axillary and tympanic temperatures, respectively.

A comparison of axillary and tympanic membrane to rectal temperatures in children

Background Core body temperature measurement is not commonly done in pediatric populations because it is invasive and difficult to perform. Therefore, axillary and tympanic membrane temperature measurements are preferable, but their accuracy is still debatable.Objective To compare the accuracy of axillary and tympanic temperatures to rectal temperature in children with fever, and to measure the cut-off point for fever based on each temperature measurement method.Methods A diagnostic study was conducted among feverish children aged 6 months to 5 years who were consecutively selected from the Pediatric Outpatient Clinic, Pediatric Emergency Unit, and the inpatient ward in the Department of Child Health, Cipto Mangunkusumo Hospital (CMH), from December 2014 to January 2015. Subjects underwent three measurements within a two minute span, namely, the axillary, tympanic membrane, and rectal temperature measurements. The values obtained from the examination were analyzed with appropriate statistical tests.Results The cut-off for fever on axilla was 37.4oC and on tympanic membrane was 37.4oC, with sensitivity 96% (95%CI 0.88 to 0.98) and 93% (95%CI 0.84 to 0.97), respectively; specificity 50% (95%CI 0.47 to 0.84) and 50% (95%CI 0.31 to 0.69), respectively; positive predictive value/PPV 90% (95%CI 0.81 to 0.95) and 85% (95%CI 0.75 to 0.91), respectively; and negative predictive value/NPV 83% (95%CI 0.61 to 0.94) and 69% (95%CI 0.44 to 0.86), respectively. The optimal cut-off of tympanic membrane and axilla temperature was 37.8oC (AUC 0.903 and 0.903, respectively).Conclusion Axillary temperature measurement is as good as tympanic membrane temperature measurement and can be used in daily clinical practice or at home. By increasing the optimum fever cut-off point for axillary and tympanic membrane temperature to 37.8oC, we find sensitivity 81% and 88%, specificity 86% and 73%, PPV 95% and 91%, and NPV 95% and 91%, respectively.

Comparison between tympanic temperature measurement with infrared ear thermometer and rectal temperature measurement with mercury clinical thermometer for children

Objective To explore the feasibility for application of infrared ear thermometer in body temperature measurement among children. Method Ear temperature and rectal temperature of 500 children patients at outpatient and emergency departments were measured and the difference between ear temperature and rectal temperature were compared with the self-control method. With 500 children patients were divided into the following groups: 0-1 year old group, > 1-2 years old group, > 2-3 years old group, > 3-7 years old group, the difference of these two measuring methods in these different age groups were compared. Results Average rectal temperature was (38.28±0.93) ℃, higher than average ear temperature (38.06±0.92) ℃ with statically significant difference (t =-12.711, P =0.000); 0-1 year old group, > 1-2 years old group, > 2-3 years old group, > 3-7 years old group, four age groups rectal temperature minus ear temperature difference results M(Q25, Q75) were as follows: 0.2(0.0, 0.5), 0.2 (0.1, 0.4) 0.2 (0.0,0.4) 0.2(0.0,0.4), which meant the difference between two temperature measurement methods in different age groups showed that the difference was not statistically significant (H=0.600, P =0.896); ear temperature and rectal temperature were linearly correlated (r=0.915, P =0.000); taking rectal temperature as Y and ear temperature as X, the regression equation was =3.080+0.925X; with rectal temperature of ≥38.0℃ as golden standard, the area in ROC curve of ear temperature was 0.97 and correct diagnosis index of ear temperature was highly correct. Therefore, as for whether a child is diagnosed as fever based on the ear temperature, it is recommended that the ear temperature be ≥37.8℃; the difference of fever incidence for rectal temperature method of 58.2% and fever incident for ear temperature method of 57.2% was determined as not statistically significant (χ2=0.102, P=0.749). Conclusions Infrared ear thermometer may be used for measuring children′s body temperature by replacing mercury rectal thermometer; however, ear temperature should be different from rectal temperature in terms of criteria for clinical judgment of fever. Key words: Children; Temperature measuring method; Infrared ear thermometer; Mercury clinical thermometer

Comparison of Axillary and Tympanic Temperature Measurements in Children Diagnosed with Acute Otitis Media.

Background. Acute otitis media [AOM] may affect the accuracy of tympanic temperature measurements. We aimed to compare tympanic temperature measurements in patients with AOM against control groups, as well as compare the tympanic temperatures with axillary thermometry. Methods. This is a prospective, observational study. Patients from pediatric outpatient and emergency clinics who were diagnosed as single-sided AOM were included consecutively in the study. Normal ears of patients and children having the same age and gender who were not diagnosed as AOM were also studied as controls. Results. In patients with AOM, infected ears had higher temperatures than normal ears with a mean of 0.48 ± 0.01°C. There was no significant difference between the right and left tympanic temperatures in control group. Compared with axillary temperature, the sensitivity of tympanic temperature in the infected ear was 91.7% and the specificity was 74.8%. Conclusion. Comparisons of axillary and tympanic temperatures in children with AOM during the active infection concluded higher tympanic temperatures in infected ears. We suggest that the higher tympanic temperatures, approximately 0.5°C in our study, in infected ears may aid in diagnosis of patients with fever without a source in pediatric clinics.

Accuracy of Tympanic Temperature Measurement in Firefighters Completing a Simulated Structural Firefighting Task.

In the course of their duties, firefighters risk heat stroke and other medical conditions due to exertion in high-temperature environments. Infrared tympanic temperature measurement (TTym) is often used by Emergency Medical Services (EMS) to assess the core body temperature of firefighters. The accuracy of TTym in this setting has been called into question. Hypothesis/Problem This study aimed to examine the accuracy of TTym for core body temperature assessment at emergency firefighting events compared with gastrointestinal temperature measurement (TGI) as measured by ingestible thermometers. Forty-five (42 male, three female) professional urban firefighters from an Australian fire service completed two 20-minute work periods in a 100°C (± 5°C) heat chamber while wearing personal protective clothing (PPC) and breathing apparatus (weighing approximately 22 kg). Measurements were taken immediately before entering, and on exiting, the heat chamber. Tympanic temperature was assessed by an infrared tympanic thermometer and TGI was measured by ingestible sensor and radio receiver. Complete data were available for 37 participants. Participant temperatures were higher on exiting the heat chamber than at baseline (TTym: 35.9°C (SD=0.7) vs 37.5°C (SD=0.8); TGI: 37.2°C (SD=0.4) vs 38.6°C (SD=0.5)). Tympanic temperature underestimated TGI on average by 1.3°C (SD=0.5) before entering the chamber and by 1.0°C (SD=0.8) following the exercise. Using pooled data, the average underestimation was 1.2°C (SD=0.7). Tympanic thermometers cause an unreliable measure of core body temperature for firefighters engaged in fire suppression activities. Accurate and practical measures of core body temperature are required urgently.