Body Core Temperature Assessment in Emergency Care Departments

Hein A.M. Daanen*, Gercora Hoitinga, David J. Kruijt, Kevin S. Koning, Pooh P. Verheijen, Sanne I.M. de Baas, Anouk R. Bergsma, Cathelijne E. Snethlage, Iman Al-Bander, Lennart P.J. Teunissen

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: There is concern that the values provided by devices using infrared thermometry in emergency departments (EDs) do not reflect body core temperature accurately. Objectives: Evaluation of three thermometers commonly used in the ED. Methods: Two infrared ear thermometers and an infrared forehead thermometer were evaluated using 1) the Voltcraft IRS-350 calibration device, 2) comparing temperature values to a rectal end-exercise temperature (T-RECT) of 38.1°C in 12 participants, and 3) comparing temperature values to rectal temperature in 133 ED patients. Results: Calibration across the human core temperature range revealed that the ear thermometers underestimated radiant temperature by 0.77 ± 0.39°C and 1.84 ± 0.26°C, respectively, whereas the forehead thermometer overestimated radiant temperature by 0.90 ± 0.51°C. After cycling exercise, all thermometers underestimated T-RECT (0.54 ± 0.27°C and 1.03 ± 0.48°C for the ear thermometers and 1.14 ± 0.38°C for the forehead thermometer). In the ED, the ear thermometers underestimated T-RECT by 0.31 ± 0.37°C and 0.46 ± 0.50°C, whereas the forehead thermometer exhibited a nonsignificant overestimation of 0.04 ± 0.46°C. If the threshold for fever in all systems had been set to 37.5°C instead of 38.0°C, the sensitivity and specificity of the systems for real fever (T-RECT ≥ 38°C) are, respectively, 71% and 96% (ear thermometer 1), 57% and 97% (ear thermometer 2), and 86% and 90% (forehead thermometer). Conclusion: We conclude that the investigated thermometers are not reliable as devices to measure radiant temperature, cannot be used to assess body core temperature during exercise, but may be used as a screening device, with 37.5°C as a threshold for fever in emergency care settings.

Original languageEnglish
Pages (from-to)e277-e283
Number of pages7
JournalJournal of Emergency Medicine
Volume66
Issue number3
Early online date14 Nov 2023
DOIs
Publication statusPublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2023 The Author(s)

Funding

We would like to acknowledge the staff of the Emergency Department of the Amsterdam UMC location AMC for their cooperation, and a special thanks to Ruud Voorn, technician, and Dr. Milan Ridderikhof PhD and MD Emergency Medicine, for their contribution to this study.

Keywords

  • arteria temporalis
  • calibration
  • exercise
  • fever
  • thermometer
  • thermometry
  • tympanic temperature

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