Limitations of infrared ear temperature measurement in clinical practice
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Limitations of infrared ear temperature measurement in clinical practice. / Twerenbold, Raphael; Zehnder, Andreas; Breidthardt, Tobias; Reichlin, Tobias; Reiter, Miriam; Schaub, Nora; Bingisser, Roland; Laifer, Gerd; Mueller, Christian.
In: SWISS MED WKLY, Vol. 140, 2010, p. w13131.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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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 -