Print

Print


Interesting discussion.
Am I right in thinking that all these rapid method of temp assessments
[eg IR and stat probes etc] use 'predictive' methods of temp assessment
based on two or more millisecond recordings and extrapolating the final
result on the basis of a sine curve that fits the samples taken? ie
don't these methods have clear accuracy issues that make talking about
'gold standards' involving these devices somewhat limited?
I'm not overly worried about the whole question too much, as I tend to
think of temp as only brushstroke in the picture. But if we want
accuracy are folk using mercury or continuous measurement temp probes?

Rob Ojala


-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of Martin Herman
Sent: Thursday, 14 February 2008 11:33 a.m.
To: [log in to unmask]
Subject: Re: Tympanic temps

Those are good points Jim.
I have to admit that I thought infrared temps had problems if the ear
canal
was clogged with cerumen so I have not paid much attention to that
technology. I guess it is similar to the stool insulating effect.

What do you think of the indirect " temporal artery" technique?

Do you think that the infra red or temporal artery techniques are
reliable
enough to allow us to apply the "guidelines" for evaluation of the
febrile
infant?


Marty

------------------------------------
Pediatric Emergency Specialists, P.C.
Martin Herman, M.D.,FAAP,FACEP
President
[log in to unmask]
PO box 637
Ellendale TN 38029
tel: 901 405 1407
fax: 901 405 1524
mobile: 901 219 9202
------------------------------------

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of Chamberlain, Jim
Sent: Tuesday, February 12, 2008 11:32 PM
To: [log in to unmask]
Subject: Re: Tympanic temps

We published norms on infrared ear temperatures in Annals of Emergency
Medicine circa 1995. I would use those.

The rectal site was chosen arbitrarily in the late 1800s. The thought at
the
time was that it was a core body temperature. We now know that blood
supply
is poor to the colon and stool has an insulating effect, thus damping
any
changes.

For any who believe rectal temperature is accurate, there was a paper
out of
Israel in mid 1990s that showed that rectal temperature varied by up to
1
deg C, depending on depth of insertion.

As far as a valid test to detect illness, temperature doesn't come close
to
anything we would normally accept for test performance. Sensitivity and
specificity are both poor.

So, why torture a kid and touch stool when the test is inaccurate
anyway?

Jim Chamberlain
Washington, DC

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List on behalf of Peter
Auerbach
Sent: Tue 2/12/2008 9:06 PM
To: [log in to unmask]
Subject: Re: Tympanic temps

Thanks for making this point,
with which I agree completely.
It's not that a rectal temp is as "accurate" as a "core body temperture"
(as
if that matters anyway),
it's that a rectal temperature is what has been used the most by the
medical
community to come up with arbitrary fever standards to help guide
decision-making.
If we all decide to use some other type of temperature measurement in
very
young infants, fine, but what are the chances that everyone's going to
agree
on that?!



> Date: Tue, 12 Feb 2008 19:34:52 -0600
> From: [log in to unmask]
> Subject: Re: Tympanic temps
> To: [log in to unmask]
>
> Isn't the rectal temp the "gold standard"?  I mean isn't it the next
best
to
> core temperature that we can access? I realize that core temp is the
body
> temp when measured via an indwelling probe and that the next best
surrogate
> is  an esophageal probe but really isn't the rectal temp what the
entire
> medical community has used for decades to decide who is sick and who
isn't?
>
>
> Marty
>
>
> ------------------------------------
> Pediatric Emergency Specialists, P.C.
> Martin Herman, M.D.,FAAP,FACEP
> President
> [log in to unmask]
> PO box 637
> Ellendale TN 38029
> tel: 901 405 1407
> fax: 901 405 1524
> mobile: 901 219 9202
> ------------------------------------
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List
> [mailto:[log in to unmask]] On Behalf Of Chamberlain, Jim
> Sent: Tuesday, February 12, 2008 4:19 PM
> To: [log in to unmask]
> Subject: Re: Tympanic temps
>
> Rectal temperature is inaccurate compared to core body temperature.
When
> temperature is changing (as in febrile conditions), rectal lags behind
> other sites (esophageal, oral, tympanic, and infrared ear thermometer)
> by 20-30 minutes.
>
> Rectal temperature is also non-hygienic.
>
> James Chamberlain, MD
> Division Chief, Emergency Medicine
> Children's National Medical Center
> Washington, DC
> 202.476.3253 Office
> 202.476.3573 Fax
> 202.476.5433 Emergency Access
> 
>
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List
> [mailto:[log in to unmask]] On Behalf Of Julia Whitefield
> Sent: Tuesday, February 12, 2008 1:37 AM
> To: [log in to unmask]
> Subject: Tympanic temps
>
> Dear all, I am finally breaking down... while in favor of rectal temps
> in < 36 months old... I don't feel like having to re-invent the wheel:
> who of you do tympanic temps in your ED - do you have good literature
> support? - and how many of you are in support of rectal temps? I
thought
> we had cleared that issue for once and for all - but I guess not!
Would
> you please give me your input?
> Thank you so
> Julia S. Whitefield MD, Ph.D.
> UNM
> ABQ, NM
> For more information, send mail to [log in to unmask] with
the
> message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>   http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
>
> Confidentiality Notice: This e-mail message, including any
attachments, is
> for the sole use of the intended
> recipient(s) and may contain confidential and privileged information.
Any
> unauthorized review, use, disclosure or distribution is prohibited.
> If you are not the intended recipient, please contact the sender by
reply
> e-mail and destroy all copies of the original message.
>
> For more information, send mail to [log in to unmask] with
the
> message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>   http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
>
> For more information, send mail to [log in to unmask] with
the
message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>   http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html

For more information, send mail to [log in to unmask] with the
message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
Confidentiality Notice: This e-mail message, including any attachments,
is
for the sole use of the intended
recipient(s) and may contain confidential and privileged information.
Any
unauthorized review, use, disclosure or distribution is prohibited.
If you are not the intended recipient, please contact the sender by
reply
e-mail and destroy all copies of the original message.


For more information, send mail to [log in to unmask] with the
message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html

For more information, send mail to [log in to unmask] with the
message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html

**************************************************************************************************
Check out our web site:  http://www.cdhb.govt.nz

This email and attachments have been scanned for content and viruses and is believed to be clean
This email or attachments may contain confidential or legally privileged information intended for the
sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message,
except as intended, is prohibited. If you received this email in error, please notify the sender and
remove all copies of the message, including any attachments. Any views or opinions expressed in
this email (unless otherwise stated) may not represent those of Canterbury District Health Board

**************************************************************************************************

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html