THE
STUDY ON THE ACCURACY OF TYMPANIC TEMPERATURE MEASUREMENT IN PAEDIATRIC
PATIENTS AGED FROM THREE MONTHS TO FOUR YEARS OLD
W. Lee, I.
Chan, MC Yiu, PH Lam, J. Wong, M.Leung, E.Chan, SK Au, et al
Department of Paediatrics, Tuen Mun Hospital, Hong Kong, CHINA
Introduction: The measurement of body temperature is one of the
most frequently performed nursing procedure everyday. Accuracy, ease and
comfort of use, time required for temperature measurement, safety and cost
are crucial determinants for choosing thermometer system used in clinical
areas especially paediatrics. Infrared tympanic thermometry is increasingly
used as a convenient and non-invasive method for detection of abnormal
temperature readings in small infants and children. However, among researchers
and disagreement on routine use of infrared tympanic thermometer for
paediatric client is present in local setting. Therefore, it is worth to
conduct a clinical study to obtain evidence based proof in the use of
infrared tympanic thermometer among paediatric clients.
Objectives: This study aimed to (1) establish the correlation
and reliability among tympanic temperature measurements and rectal
temperature measurements and (2) compare the accuracy of tympanic
temperature measurements with rectal temperature measurements in children
aged from three months old to below four years old.
Methods: This study used a sample of 200 children from general
paediatric wards. All admitted children were recruited within the age
range, with any diagnosis except otitis media and diarrhoea, no impacted
ear wax, no head injury nor cerebral spinal fluid leakage, and no
significant ear pathology that have been proved to affect the accuracy of
tympanic thermometry. Body temperature were taken rectally and from both ears
simultaneously. The readings were computed to reveal the relationship
between the tympanic and rectal temperature.
Result: Upon analysis, correlation between rectal and
bilateral tympanic temperature readins was statistically high (r=0.89 in
rectal and right tympnic, r=0.88 in rectal and left tympanic, p< 0.05 in
both). The absolute mean difference between rectal and tympanic temperature
was less than 0.5ºC. The sensitivity and specificity in detection of high
fever (>38.5ºC) by tympanic thermometer were 86% and 96% respectively.
Conclusion: Reviewing the strong correlation with rectal
thermometry, good sensitivity and specificity in detection of fever, ease
and comfort of use as well as cost effectiveness, infrared tympanic
thermometer as temperature assessment tool in children aged from three
months to four years was recommended in this study.