Accuracy of parents in measuring body temperature with a tympanic thermometer

Robinson, Joan L; Jou, Hsing; Spady, Donald W

With the recent outbreak of Severe Acute Respiratory Syndrome, rapid measurement of body temperature (sometimes by personnel who are not health care workers) has become an important tool to indicate if people can board airplanes and if staff can work. It is therefore important to determine the accuracy of non-health care workers at measuring body temperature. This study showed that the temperatures measured by parents with a tympanic ther-mometer often differ by a clinically significant amount from those measured by a nurse with a tympanic thermometer. There is not a consistent gradient or direction of the gradient between the two temperatures, which makes it difficult to interpret the temperatures reported by parents. There was a smaller gradient between the readings taken by a nurse with a tympanic thermometer designed for home use compared with those taken with a model of tympanic thermometer commonly used in hospitals, but there were still potentially clinically significant discrepancies 14% of the time. This makes it difficult to conclude if the poor performance of the parents relates entirely to human error, or if there is also an element of instrument error. The fact that in comparison with our reference standard (tympanic temperature measured by the Scatter plot of the difference between temperature measured by a parent using a thermometer designed for home use and a nurse using a thermometer designed for hospital use Figure 3 Scatter plot of the difference between temperature measured by a parent using a thermometer designed for home use and a nurse using a thermometer designed for hospital use nurse with a hospital thermometer) the readings taken with the home thermometer by the nurse correlated much better than those taken by the parent suggests that the parents did not use ideal technique. In any case, one should interpret temperatures taken by parents with a tympanic thermometer with great caution. Although parents will detect the majority of fevers with these instruments, the absolute numbers obtained may not be accurate. Again, we find that in pediatrics, the clinical picture is a more useful piece of information than are "the numbers"! Abbreviations°C -degrees Celsius PA: pulmonary artery Scatter plot of the difference between temperature measured by a nurse using a thermometer designed for home use and a a thermometer designed for hospital use Figure 4 Scatter plot of the difference between temperature measured by a nurse using a thermometer designed for home use and a a thermometer designed for hospital use