Daanen Hein A M, Hoitinga Gercora, Kruijt David J, Koning Kevin S, Verheijen Pooh P, de Baas Sanne I M, Bergsma Anouk R, Snethlage Cathelijne E, Al-Bander Iman, Teunissen Lennart P J
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Emergency Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands.
J Emerg Med. 2024 Mar;66(3):e277-e283. doi: 10.1016/j.jemermed.2023.10.027. Epub 2023 Nov 14.
There is concern that the values provided by devices using infrared thermometry in emergency departments (EDs) do not reflect body core temperature accurately.
Evaluation of three thermometers commonly used in the ED.
Two infrared ear thermometers and an infrared forehead thermometer were evaluated using 1) the Voltcraft IRS-350 calibration device, 2) comparing temperature values to a rectal end-exercise temperature (T-RECT) of 38.1°C in 12 participants, and 3) comparing temperature values to rectal temperature in 133 ED patients.
Calibration across the human core temperature range revealed that the ear thermometers underestimated radiant temperature by 0.77 ± 0.39°C and 1.84 ± 0.26°C, respectively, whereas the forehead thermometer overestimated radiant temperature by 0.90 ± 0.51°C. After cycling exercise, all thermometers underestimated T-RECT (0.54 ± 0.27°C and 1.03 ± 0.48°C for the ear thermometers and 1.14 ± 0.38°C for the forehead thermometer). In the ED, the ear thermometers underestimated T-RECT by 0.31 ± 0.37°C and 0.46 ± 0.50°C, whereas the forehead thermometer exhibited a nonsignificant overestimation of 0.04 ± 0.46°C. If the threshold for fever in all systems had been set to 37.5°C instead of 38.0°C, the sensitivity and specificity of the systems for real fever (T-RECT ≥ 38°C) are, respectively, 71% and 96% (ear thermometer 1), 57% and 97% (ear thermometer 2), and 86% and 90% (forehead thermometer).
We conclude that the investigated thermometers are not reliable as devices to measure radiant temperature, cannot be used to assess body core temperature during exercise, but may be used as a screening device, with 37.5°C as a threshold for fever in emergency care settings.
人们担心急诊科（ED）中使用红外测温法的设备所提供的值不能准确反映人体核心温度。
评估急诊科常用的三种体温计。
使用以下方法评估两种红外耳温计和一种红外额温计：1）Voltcraft IRS - 350校准设备；2）将12名参与者的温度值与直肠运动后体温（T - RECT）38.1°C进行比较；3）将133名急诊科患者的温度值与直肠温度进行比较。
在人体核心温度范围内进行校准发现，耳温计分别将辐射温度低估了0.77±0.39°C和1.84±0.26°C，而额温计将辐射温度高估了0.90±0.51°C。循环运动后，所有体温计均低估了T - RECT（耳温计分别低估0.54±0.27°C和1.03±0.48°C，额温计低估1.14±0.38°C）。在急诊科，耳温计分别将T - RECT低估了0.31±0.37°C和0.46±0.50°C，而额温计显示出非显著的高估，高估了0.04±0.46°C。如果所有系统的发热阈值设定为37.5°C而非38.0°C，那么这些系统对于真正发热（T - RECT≥38°C）的敏感度和特异度分别为：71%和96%（耳温计1）、57%和97%（耳温计2）、86%和90%（额温计）。
我们得出结论，所研究的体温计作为测量辐射温度的设备不可靠，不能用于评估运动期间的人体核心温度，但可作为筛查设备，在急诊护理环境中以37.5°C作为发热阈值。
