The accuracy of the tympanic membrane thermometer in detecting fever in infants aged 3 months and younger in the emergency department setting.

OBJECTIVE

To evaluate the accuracy of fever detection using the tympanic membrane thermometer in infants age 3 months and younger in a general ED clinical setting.

DESIGN

Retrospective analysis of sequential tympanic and rectal temperature readings for sensitivity, specificity, and predictive values.

SUBJECTS

One hundred two infants, aged 3 months and younger, coming to the emergency department from January 1991 to July 1991.

RESULTS

With fever defined as a temperature of 99.6 degrees F or greater by tympanic thermometer or 100.6 degrees F or greater by rectal thermometer, the tympanic thermometer had an overall specificity for fever detection of 88%. Sensitivity was 90% or higher in the 2-month-old and younger age groups and 66% in the 3-month-old age group. Negative predictive values were 90% and greater and positive predictive values ranged from 60% to 66%.

CONCLUSION

The tympanic membrane thermometer provided a reliable temperature reading in a high percentage of the sample population when the infant was afebrile. It was less reliable in detecting the presence of fever in this same age group. Febrile temperature readings obtained by the tympanic membrane thermometer within this age group may need to be compared with a rectal mode reading to accurately determine the presence of fever.