• Marcia Reynolds, Laura Bonham, Margaret Gueck, Katherine Hammond, Jessica Lowery, Cheryll Redel, Christine Rodriguez, Suzanne Smith, Anne Stanton, Stephanie Sukosd, and Marla Craft.
• Portland, OR. Electronic address: marcia.reynolds@providence.org.
• J Emerg Nurs. 2014 Jan 1;40(1):46-50.

ObjectiveThis study examined the accuracy of temporal artery and axillary temperatures compared with rectal temperatures in pediatric ED patients younger than 4 years.MethodsA method-comparison study design was used to examine the agreement between a temporal artery or axillary thermometer and a nondisposable, rectal electronic thermometer, which is the clinical reference standard for temperature measurement in children. Temperatures were taken with each device in a convenience sample of stable, pediatric ED patients who were younger than 4 years. Bias and precision were calculated to quantify the differences between the 2 devices, as well as the percentage of temporal artery and axillary temperatures that were >±1.0°C and >±1.5°C higher or lower than the rectal temperature.ResultsA total of 52 pediatric ED patients were studied over a 10-month period. Bias and precision for the temporal artery and axillary devices were -0.46°C ± 0.50°C and -0.93°C ± 0.49°C, respectively. The percentage of temporal artery and axillary temperatures that were >±1.0°C and/or >±1.5°C above or below the clinical reference temperature were 15% and 6%, respectively, for the temporal artery thermometer and 39% and 14%, respectively, for the axillary thermometer.DiscussionBias and precision values for the temporal artery, but not the axillary temperature, were within the acceptable range set by experts to use as a noninvasive substitute for core body temperature measurements. If properly used by ED staff, temporal artery thermometers could be used to obtain temperature in pediatric patients younger than 4 years, thus avoiding physical and psychological discomfort for the child and parent associated with obtaining rectal thermometers.Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

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