Limitations of infrared ear temperature measurement in clinical practice

TY - JOUR

T1 - Limitations of infrared ear temperature measurement in clinical practice

AU - Twerenbold, Raphael

AU - Zehnder, Andreas

AU - Breidthardt, Tobias

AU - Reichlin, Tobias

AU - Reiter, Miriam

AU - Schaub, Nora

AU - Bingisser, Roland

AU - Laifer, Gerd

AU - Mueller, Christian

PY - 2010

Y1 - 2010

N2 - PRINCIPLES: Detection of elevated body temperature is critical in the early diagnosis of sepsis. Due to its convenience, infrared ear temperature measurement (IETM) has become the standard of care. Unfortunately, the limitations of this method are largely unexplored.OBJECTIVE: To evaluate potential limitations of IETM, including the presence of cerumen on otoscopy, depth of penetration, side of measurement, and the impact of acclimatisation to room temperature.METHODS: In this prospective cohort study, 333 patients presenting to the medical emergency department underwent serial IETM before and after otoscopy and cleaning of the external auditory canal. The primary endpoint was defined as mean change in infrared ear temperature (IET) before and after removal of cerumen. We also tested for the effect of penetration depth, side of measurement and impact of acclimatisation.RESULTS: Otoscopy revealed cerumen in 98 patients (29%). Cerumen had a weak but statistically significant impact on IETM. The removal of cerumen obturans resulted in a rise in IET of 0.20 °C (95% CI 0.10-0.28 °C, P = 0.03). The effects of penetration depth (P = 0.39), side of measurement (P = 0.78) and impact of acclimatisation (P = 0.82) were not significant.CONCLUSIONS: Cerumen has a statistically significant, albeit not clinically meaningful, influence on IETM. Thus routine ear inspection prior to the use of IETM is not warranted. IETM provides highly reproducible assessments of IET irrespective of penetration depth, side of measurement and acclimatisation.

AB - PRINCIPLES: Detection of elevated body temperature is critical in the early diagnosis of sepsis. Due to its convenience, infrared ear temperature measurement (IETM) has become the standard of care. Unfortunately, the limitations of this method are largely unexplored.OBJECTIVE: To evaluate potential limitations of IETM, including the presence of cerumen on otoscopy, depth of penetration, side of measurement, and the impact of acclimatisation to room temperature.METHODS: In this prospective cohort study, 333 patients presenting to the medical emergency department underwent serial IETM before and after otoscopy and cleaning of the external auditory canal. The primary endpoint was defined as mean change in infrared ear temperature (IET) before and after removal of cerumen. We also tested for the effect of penetration depth, side of measurement and impact of acclimatisation.RESULTS: Otoscopy revealed cerumen in 98 patients (29%). Cerumen had a weak but statistically significant impact on IETM. The removal of cerumen obturans resulted in a rise in IET of 0.20 °C (95% CI 0.10-0.28 °C, P = 0.03). The effects of penetration depth (P = 0.39), side of measurement (P = 0.78) and impact of acclimatisation (P = 0.82) were not significant.CONCLUSIONS: Cerumen has a statistically significant, albeit not clinically meaningful, influence on IETM. Thus routine ear inspection prior to the use of IETM is not warranted. IETM provides highly reproducible assessments of IET irrespective of penetration depth, side of measurement and acclimatisation.

KW - Aged

KW - Body Temperature

KW - Ear

KW - Female

KW - Humans

KW - Infrared Rays

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Thermography

U2 - 10.4414/smw.2010.13131

DO - 10.4414/smw.2010.13131

M3 - SCORING: Journal article

C2 - 21181568

VL - 140

SP - w13131

JO - SWISS MED WKLY

JF - SWISS MED WKLY

SN - 1424-7860

ER -