Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1999 Mar;80(3):262–266. doi: 10.1136/adc.80.3.262

Tympanic membrane temperature as a measure of core temperature

C Childs 1, R Harrison 1, C Hodkinson 1
PMCID: PMC1717865  PMID: 10325708

Abstract

BACKGROUND—Ear thermometers are becoming popular as a method for measuring deep body (core) temperature.
AIM—To determine the variability of a single user's tympanic membrane (ear) temperature measurements.
SUBJECTS—Forty two, afebrile, healthy children, and 20 febrile children with acute burns.
RESULTS—In afebrile children measurements made in both ears (and within just a few minutes of each other) differed by as much as 0.6°C. Operator measurement error, sw of three consecutive measurements, in the same ear, was 0.13°C. In the group of febrile, burned children, core temperature was measured hourly at a number of sites (ear, rectum, axilla, bladder). A peak in core temperature occurred approximately 10-12 hours after the burn. Measurement error was calculated in 14 febrile, burned children with a peak temperature in excess of 38°C. For the left ear, measurement error was 0.19°C and for the right ear, 0.11°C. In the febrile children agreement between the ears was poor. The limits of agreement were 0.4°C to −0.8°C. It was not possible to predict the occasions when the temperature differences between the ears would be large or small.
CONCLUSIONS—The measurement error of one recording from the next is probably acceptable at about 0.1 to 0.2°C. To limit the variations in temperature of one ear to the other, measurements should be restricted to one of the ears whenever possible and the same ear used throughout the temperature monitoring period. Nurses and parents should take more than one temperature reading from the same ear whenever possible. 



Full Text

The Full Text of this article is available as a PDF (137.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benzinger T. H. Heat regulation: homeostasis of central temperature in man. Physiol Rev. 1969 Oct;49(4):671–759. doi: 10.1152/physrev.1969.49.4.671. [DOI] [PubMed] [Google Scholar]
  2. Bland J. M., Altman D. G. Measurement error. BMJ. 1996 Jun 29;312(7047):1654–1654. doi: 10.1136/bmj.312.7047.1654. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  4. Brogan P., Childs C., Phillips B. M., Moulton C. Evaluation of a tympanic thermometer in children. Lancet. 1993 Nov 27;342(8883):1364–1365. doi: 10.1016/0140-6736(93)92275-x. [DOI] [PubMed] [Google Scholar]
  5. Childs C. Fever in burned children. Burns Incl Therm Inj. 1988 Feb;14(1):1–6. doi: 10.1016/s0305-4179(98)90033-x. [DOI] [PubMed] [Google Scholar]
  6. Childs C., Little R. A. Acute changes in oxygen consumption and body temperature after burn injury. Arch Dis Child. 1994 Jul;71(1):31–34. doi: 10.1136/adc.71.1.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Edge G., Morgan M. The genius infrared tympanic thermometer. An evaluation for clinical use. Anaesthesia. 1993 Jul;48(7):604–607. doi: 10.1111/j.1365-2044.1993.tb07127.x. [DOI] [PubMed] [Google Scholar]
  8. Fox R. H., Woodward P. M., Fry A. J., Collins J. C., MacDonald I. C. Diagnosis of accidental hypothermia of the elderly. Lancet. 1971 Feb 27;1(7696):424–427. doi: 10.1016/s0140-6736(71)92414-7. [DOI] [PubMed] [Google Scholar]
  9. Fraden J., Lackey R. P. Estimation of body sites temperatures from tympanic measurements. Clin Pediatr (Phila) 1991 Apr;30(4 Suppl):65–72. doi: 10.1177/0009922891030004S20. [DOI] [PubMed] [Google Scholar]
  10. Haddock B. J., Merrow D. L., Swanson M. S. The falling grace of axillary temperatures. Pediatr Nurs. 1996 Mar-Apr;22(2):121–125. [PubMed] [Google Scholar]
  11. Hooker E. A. Use of tympanic thermometers to screen for fever in patients in a pediatric emergency department. South Med J. 1993 Aug;86(8):855–858. doi: 10.1097/00007611-199308000-00001. [DOI] [PubMed] [Google Scholar]
  12. Kelly B., Alexander D. Effect of otitis media on infrared tympanic thermometry. Clin Pediatr (Phila) 1991 Apr;30(4 Suppl):46–49. doi: 10.1177/0009922891030004S13. [DOI] [PubMed] [Google Scholar]
  13. Pransky S. M. The impact of technique and conditions of the tympanic membrane upon infrared tympanic thermometry. Clin Pediatr (Phila) 1991 Apr;30(4 Suppl):50–60. doi: 10.1177/0009922891030004S15. [DOI] [PubMed] [Google Scholar]
  14. Rhoads F. A., Grandner J. Assessment of an aural infrared sensor for body temperature measurement in children. Clin Pediatr (Phila) 1990 Feb;29(2):112–115. doi: 10.1177/000992289002900209. [DOI] [PubMed] [Google Scholar]
  15. Romanovsky A. A., Quint P. A., Benikova Y., Kiesow L. A. A difference of 5 degrees C between ear and rectal temperatures in a febrile patient. Am J Emerg Med. 1997 Jul;15(4):383–385. doi: 10.1016/s0735-6757(97)90133-9. [DOI] [PubMed] [Google Scholar]
  16. Shenep J. L., Adair J. R., Hughes W. T., Roberson P. K., Flynn P. M., Brodkey T. O., Fullen G. H., Kennedy W. T., Oakes L. L., Marina N. M. Infrared, thermistor, and glass-mercury thermometry for measurement of body temperature in children with cancer. Clin Pediatr (Phila) 1991 Apr;30(4 Suppl):36–49. doi: 10.1177/0009922891030004S11. [DOI] [PubMed] [Google Scholar]
  17. Stoner H. B., Barker P., Riding G. S., Hazlehurst D. E., Taylor L., Marcuson R. W. Relationships between skin temperature and perfusion in the arm and leg. Clin Physiol. 1991 Jan;11(1):27–40. doi: 10.1111/j.1475-097x.1991.tb00651.x. [DOI] [PubMed] [Google Scholar]
  18. Terndrup T. E., Milewski A. The performance of two tympanic thermometers in a pediatric emergency department. Clin Pediatr (Phila) 1991 Apr;30(4 Suppl):18–35. doi: 10.1177/0009922891030004S07. [DOI] [PubMed] [Google Scholar]
  19. Yeo S., Scarbough M. Exercise-induced hyperthermia may prevent accurate core temperature measurement by tympanic membrane thermometer. J Nurs Meas. 1996 Winter;4(2):143–151. [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES