Non-invasive No-Touch Temporal Thermometers?

~PedsRN~, BSN, RN · Apr 7, 2015

Notoriously unreliable, along with tympanic thermometers. Just used one that a parent brought in this weekend - read 94.4. Rectal temp was 97.9. Quite a bit of difference.

OldDude · Apr 7, 2015

Notoriously unreliable, along with tympanic thermometers. Just used one that a parent brought in this weekend - read 94.4. Rectal temp was 97.9. Quite a bit of difference.

Agree...I've tried different types over the years but I always revert to the oral thermometer for most of the kids.

That Guy, BSN, RN, EMT-B · Apr 7, 2015

You mean random number generators....yeah not accurate at all.

blondy2061h, MSN, RN · Apr 7, 2015

I keep reading all these articles about how accurate they are in journals. The ONS just published one in the journal I got yesterday. But in reality they're awful. I'm get numbers ranging across a 3 degree centigrade range. I think the company that makes them has deep pockets. I know they're very expensive.

ohiobobcat · Apr 7, 2015

I bought one for my school nurse office and I have noticed a significant difference, 2-3 degrees F sometimes, difference between my oral and scanning thermometer. Right out of the box, the scanning thermometer read me as having a fever of 101.6 F. I thought "Sweet!! I can go home!!" I most definitely was not sick that day, either.

nurseprnRN, BSN, RN · Apr 7, 2015

Notoriously unreliable, along with tympanic thermometers. Just used one that a parent brought in this weekend - read 94.4. Rectal temp was 97.9. Quite a bit of difference.

While they may or may not be accurate at reading a temperature, the fact that it isn't the same as a rectal temp is not why. The gold standard for body temp is pulmonary artery (core) blood temp, because that's where all the blood (of different temperatures) in the body are fully mixed. So when a study compares a temperature-taking method for validity, it should do so comparing it to PA temp. (Rectal temp is less reflective of core temp than axillary in hypothermia, too.)

Here's a study that will be of interest. Among its findings: "By definition, fever is an elevation in internal temperature, which is a key clinical indicator of an infection. Exercise, as well as exposure to high ambient temperatures, can increase core temperature to precariously high levels, potentially culminating in severe heat illness and death.^[5,6] The use of an accurate technique for the clinical assessment of body temperature in these and related conditions is critical for the appropriate evaluation of the patient. Inaccurate temperature readings ultimately can lead to incorrect diagnosis, delay of appropriate treatment, and subsequent permanent injury or death. The present data demonstrate that the temporal scanning technique does not accurately track increases in core temperature during passive heating. This observation strongly suggests that patients might be misdiagnosed if the user solely relies on these devices as an accurate indicator of internal temperature."

and

"Another potential limitation of the use of the temporal scanning device is the reported assumption that the device is actually measuring the temperature of the temporal artery (U.S. patent 6292685^[9]). The temporal scanner has no way of identifying the location of the temporal artery. Rather, the device, using infrared thermometry, takes rapid samples of temperature as the device is drawn across the patient's forehead; it is presumed that the highest temperature reading originates from the temporal artery. However, if the highest temperature reading occurs in an area remote from the temporal artery, the device will use that reading in the calculation of internal temperature. The recommendation that temperature be assessed behind the ear for diaphoretic subjects further demonstrates that this device does not rely solely on the temporal artery for its measure, because the temporal artery is not located behind the ear."

Medscape: Medscape Access

Annie Wilkes RN · Apr 9, 2015

Thank you for your replies!

KelRN215, BSN, RN · Apr 10, 2015

The ONLY time I've ever seen these was when I was "screened" for Ebola crossing the border between Kenya and Uganda last October. Every single person that went through had a temp of between 36.1-36.4 C.

I prefer good old oral or axillary any day. I hate tympanic or temporal in children.

BrandonLPN, LPN · Apr 10, 2015

Don't personally have much experience with temporal thermometers, but CNAs getting notoriously unreliable temperatures with tympanic ones is part of the reason I get my own vitals. That and the disheartening number of times I've seen residents with respiratory rates of 10 or 40 that were all charted as the Magic 18.

In defense of tympanic thermometers though, they doâ€‹ work provided one gets it in far enough and actually points it toward the tympanic membrane. It's just so many of my aides seem to think getting a kinda-sorta temp of the external ear is good enough.