Axillary, Tympanic, and Temporal Thermometry Comparison in a Community Hospital Pediatric Unit

Emma Kurnat-Thoma; Vanessa Edwards; Kathleen Emery


Pediatr Nurs. 2018;44(5):235-246. 

In This Article

Abstract and Introduction


Accurate temperature assessment in pediatric practice is of critical importance when diagnosing, treating, and monitoring illness. No official standardized clinical research identifies a thermometry measurement method meeting all practice needs for all combined pediatric ages and practice settings. We conducted an IRB-approved research study in 140 Pediatric Unit patients and examined the Exergen Temporal Scanner™ (TAT)-5000 compared to the current practices of axillary thermometry for newborn infants (ages 0 to 3 months), and tympanic thermometry for children and adolescents (3 months to 21 years old). Patient and room temperatures, demographic data, and clinical data were collected. Paired sample t tests and Bland-Altman analyses were used to examine thermometry differences and define statistical equivalence between thermometry methods. Mean axillary (98.06°F) and TAT (98.92°F) temperatures in newborns were significantly different [t (52) = -9.33, p<0.001], as were mean tympanic (98.06°F) and TAT (99.31°F) child-adolescent temperatures [t (72) = -11.28, p<0.001]. TAT was least impacted by ambient air temperature and statistically comparable to axillary thermometry, but not tympanic thermometry. TAT would be an adequate thermometry alternative for general pediatrics inpatients for body temperature monitoring in conditions such as asthma, hyperbilirubinemia, pneumonia, tonsillectomy, and post-operative appendectomy.


Body temperature is a key vital sign parameter to evaluate physical health status (Bahorski et al., 2012). In pediatric practice environments, accurate temperature assessments are a critical requirement in determining the presence or absence of fever and monitoring thermoregulatory changes (Hockenberry & Wilson, 2009). Fevers do not always portend presence of serious health alterations; elevated body temperature is a common and normal physiologic response to defending the body against infectious or inflammatory stimuli (Clark, 2014). The American Academy of Pediatrics (AAP) (2007) states normal temperature in children is 97.5 degrees Fahrenheit (°F) to 99.5°F and recommends rapid workup of fever (>100.4°F) in infants under 3 months of age to prevent rapid health decompensations. Inaccurate thermometry can lead to false-positive fever detection and consume significant resources in unnecessary diagnostic work-ups and medical treatments (e.g., sepsis), while false-negative detections can delay diagnosis and treatment of serious illnesses (Zhen, Xia, Long, & Pu, 2014).