Don't Rely on Peripheral Thermometers to Accurately Estimate Temperature — Physician’s First Watch

Medical News |
November 16, 2015

Don't Rely on Peripheral Thermometers to Accurately Estimate Temperature

By Jenni Whalen

Edited by David G. Fairchild, MD, MPH

Peripheral thermometers do not accurately estimate body temperature, suggests a meta-analysis from the Annals of Internal Medicine.

Researchers reviewed data from roughly 8700 patients in 75 prospective studies that compared peripheral thermometers (tympanic membrane, temporal artery, axillary, or oral) with central thermometers (pulmonary artery catheter, urinary bladder, esophageal, or rectal).

Peripheral thermometers were less accurate than central thermometers. Sensitivity for fever detection was low for peripheral thermometers (64%), although high-quality data were not available for all thermometer types. The authors note that during fever or hypothermia, peripheral thermometers may differ from actual body temperature by 1 to 2 degrees.

They conclude that peripheral thermometers "should not be used when accurate measurement of body temperature will influence clinical decisions... Rectal thermometers could be used for most of these patients, and bladder thermometers could be used for those requiring a bladder catheter. When a central thermometer is best avoided (for example, in patients with neutropenia) or impractical, electronic oral thermometers (for use in adults) or tympanic membrane thermometers (for use in adults and children) that are calibrated before use seem to be the best alternative."

Reader Comments (2)

Norma MT Braun, MD Physician, Internal Medicine, Hospital

I have never seen any calibration of electronic thermometers pre-use in hospital. Is there any regulations in palce regarding this as a quality iddue?

William DeMedio Physician, Family Medicine/General Practice, Private

I have known for years that IR air TM, temporal, oral thermocouple, and the other new devices used for temperature measurement have been much less than satisfactory. I do not rely on them for family members. I have seen significant differences compared to the old mercury thermometers I own. Likewise, the mercury manometer is better than the electronic pressure sensors for BP measurement.

It made no sense to do away with the old mercury oral/rectal thermometers. It also made no sense to remove the mercury sphygmomanometers. These devices were highly accurate and reproducible, as well as safe. Liquid mercury enclosed in a glass container does not leak vapor into the surroundings.

Now Ubiquitous compact fluorescent bulbs and gallium arsenide LED's leak much more toxic products into the environment than the mercury based devices that used to be only found in Doctor's offices and Hospitals. Perhaps we should have kept the incandescent lights as well as the mercury devices.

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