![]() ![]() ![]() Prior to the data collection, the maximum allowed difference between the two measurements was set to ± 0.3 ☌. The limits of agreement (LOA) frames the interval where 95% of the differences between the temperatures measured by TAT and digital REC transpires. To minimise measurement bias and potential inter-user variation, the same clinical nurse specialist conducted all measurements.īland-Altman analysis was used to analyse the difference between the two measuring methods. This approach was used because digital REC is considered the “gold standard”, and the initial measurement of TAT eliminated any expectations of the result before measurement. In all cases, the TAT was performed before the digital REC. The two measurements were performed immediately after each other with no more than seven minutes separating them. The measurements were read on the displays and immediately written on a prefabricated chart. The rectal temperature was measured approximately 1.5 cm proximally to the anal sphincter. The TAT calculates body temperature based on a peak of a forehead scan, measuring skin temperature just above the temporal artery and its surroundings. Hygienic precautions from the hospital and the manufacturers were followed. Both instruments were unused prior to the initiation of the study and were used according to the manufacturer’s instructions. Measurements of temporal artery temperature were collected with an infrared thermometer, and the rectal measurements were collected using a digital REC. Hence, the analysis was completed on 381 patients with data on both temporal and rectal temperature measurements. Four patients were excluded due to constipation found during the measurement of the rectal temperature. The exclusion criteria were cognitive impairment (due to inability to give informed consent and receive instructions about the REC measurement procedure), constipation, rectum removed surgically and anal disorders such as haemorrhoids or wounds, which would cause discomfort for the patient during the rectal measurement.Ī total of 385 (59%) patients were included in the study. The inclusion criteria were age ≥ 18 years and informed consent. All patients presenting in daytime on weekdays were screened for eligibility. The study was conducted from March to April 2013 at the ED, at Bispebjerg and Frederiksberg Hospital. This was a prospective comparative study of body temperature measurements using the TAT and a conventional digital rectal thermometer (REC). To renew attention to this important topic and to add to generalisability, we designed a study using our previously collected but unpublished data with the aim of comparing temporal and rectal measurements of body temperature in adults (≥ 18 years) presenting with medical issues at our ED. ![]() The latter study argued that TAT measurements should be used only in special circumstances when rectal or oral measurements are impractical. Similar results were found more recently in cancer patients and in a geriatric cohort. These studies found that TAT had a low diagnostic accuracy. ![]() Only few studies have been performed on adults (≥ 75 years) at the ED presenting with a medical issue. This has raised concern of potentially compromised patient safety and need of renewed attention to the use of TAT as an alternative to rectal measurements.Ĭurrent literature on the use of non-invasive temperature measurements is primarily based on studies performed on surgical, intensive care unit or paediatric patients. However, despite local incidences in which TAT measurements incorrectly identified patients as normothermic, in-house non-published research and recent systematic reviews and meta-analyses concluding that the TAT is not sufficiently accurate to replace rectal temperature measurement, TAT is still being used. Because of its ease of use and disinfection, the TAT is a convenient alternative to rectal measurements, which matches the functional demands of the ED. Over the past ten years, various digital thermometers for non-invasive use have been used increasingly in Danish hospitals, including the temporal artery thermometer (TAT). Hence, body temperature contributes to establishing parameters for diagnosis, treatment and evaluation of care and treatment. The body temperature is used systematically combined with saturation, respiration rate, blood pressure and pulse to create an early warning score used to rate, evaluate and identify critical diseases in patients. This is particularly problematic during the initial triage in the emergency department (ED) before the patient is admitted to a hospital bed. However, in addition to patient discomfort, the privacy requirements of rectal temperature measurement are inherently more resource demanding than non-invasive methods. In Denmark, rectal measurement of body temperature is considered equivalent to an invasive measure. ![]()
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