Temporal Thermometers - accuracy?

[cbrsmurf]

I've seen a couple ED's use temporal thermometers and am wondering how accurate these thermometers are. A quick review of the abstracts on pubmed appears to show that half the studies say they are accurate and the other states that they are not. Also, a majority of the studies seemed to have been conducted on the pediatric population.

 

1) Anyone use one at their work?

2) Is there a landmark/definitive study that validates this type of measurement?

3) Are they accurate when used on adults?

[dreatx]

I use them on the ambulance. I think the accuracy is terrible. I guess they can be useful if getting an oral or rectal is too hard. But, I can't see that happening in a hospital.

[Timon]

I used one for two months supplemental to the oral and rectal thermometers at my ER (Im an ER Tech and take temps on everyone who comes in 30 days and older of age). I found them to be highly inaccurate. I did my best to rule out user error as well by having other staff members use them which confirmed their unreliability. I also tested three different brands of temporal scanners. One such instance I can recall was a septic patient. Temporal came back at 98.2 versus rectal temp of 105.3.

[dannydude57]

You should add 4) How does one properly use a Temporal Thermometer?

 

As an ER RN in a small ED, I often take my patient's vital signs, including temp. One thing I noticed is instruments are only as accurate as its application. Use it wrong, get wrong results. Use it properly, get great results. For example, lodging the rectal thermometer's probe in stool can skew its results. Not properly straightening the external auditory canal interferes with tympanic thermometer accuracy. I often see patients whose oral temp doesn't match their clinical presentation. They are tachycardic, have complaints of fever/chills, "feels ill," productive cough, etc. A repeat oral temp (after being NPO) about 1/2 - 1 hours later shows a higher temp ( sometimes as much as 3 - 4 degrees F).

 

The point of the story is, how are these temporal thermometers used in these studies? Are the sensor probes correctly scanned over the temporal artery? What is the efficacy of the dual detection method (measuring the temporal artery across the forehead and temple and the carotid artery from the posterior ear down the lateral neck)? If each of these studies are using the thermometers consistently, then I would question their accuracy.

[cupojava]

Anectodal: So I had surgery last year and the tech used one of these temporal temp on me which, of course, I thought "this can't be accurate." So when he left, I used the oral temp connected to the vitals machine in the room. Anyway, it was pretty accurate within .1 degree of the temporal temp. Seriously though, one of my classmates in PA school did his senior seminar on this and his evidence showed it was supposed to be accurate. I just looked in PubMed and the first 5 articles all say it was accurate but I didn't see any RCTs and the number of patients were fairly low. We still used old fashioned stuff (oral, tympanic) here in FP.

[SwarleyWoo]

I would definitely have to agree with dannydude57's statement:

 

You should add 4) How does one properly use a Temporal Thermometer?

 

As an ER RN in a small ED, I often take my patient's vital signs, including temp. One thing I noticed is instruments are only as accurate as its application. Use it wrong, get wrong results. Use it properly, get great results. For example, lodging the rectal thermometer's probe in stool can skew its results. Not properly straightening the external auditory canal interferes with tympanic thermometer accuracy. I often see patients whose oral temp doesn't match their clinical presentation. They are tachycardic, have complaints of fever/chills, "feels ill," productive cough, etc. A repeat oral temp (after being NPO) about 1/2 - 1 hours later shows a higher temp ( sometimes as much as 3 - 4 degrees F).

 

The point of the story is, how are these temporal thermometers used in these studies? Are the sensor probes correctly scanned over the temporal artery? What is the efficacy of the dual detection method (measuring the temporal artery across the forehead and temple and the carotid artery from the posterior ear down the lateral neck)? If each of these studies are using the thermometers consistently, then I would question their accuracy.

 

I currently work as a Patient Care Tech and I take temperatures mostly tympanically. We primarily use tympanic thermometers in this hospital. I will occasionally use axillary or oral temperatures if I cannot access their ears due to bandages. Sometimes they are accurate, and sometimes they are not. Even between tympanic thermometers the results may vary. I generally test them on myself and use the one that best correlates with my normal temperature. Also, due to differentiating ear structures among patients, sometimes it is a little harder to access the ear canal. Therefore, sometimes I think the results can be skewed due to how they are used and whether they need to be recalibrated.

[ToppDog]

Tympanic was all the rage when it came out, & was found to be not very reliable, and, in my opinion, the same will happen with the temporal thermometers. Some brands may be fine, but there are others that are crap. Yes, I agree that proper use also comes into play, but that doesn't change the outcome in the end - inaccurate readings. The older methods are still the best, both in accuracy & ease of use.