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Comparison of Ear to Rectal Temperature Measurements in Infants and Toddlers

Elmwood Pediatrics, Rochester, NY

Irene Dutko-Fioravanti, MS, RN

Clinical Nursing Department, University of Rochester School of Nursing, Rochester, NY

Shirley W. Eberly, MS

Department of Biostatistics, University of Rochester School of Medicine and Dentistry, Rochester, NY

Keith R. Powell, MD

Department of Pediatric Medicine, Children's Hospital Medical Center of Akron and Northeastern Ohio Universities College of Medicine, Akron, Ohio

The purpose of this study was to compare arterial heat balance ear temperature measurements to rectal temperatures in infants and children and to determine the ability of the ear thermometer being tested to detect fever. From 12/95 to 2/96, 1,175 pairs of ear and rectal temperature measurements were prospectively obtained from 140 infants and toddlers. The mean rectal temperature was 37.58° (sd=0.68) and the mean ear temperature was 37.60'C (sd=0.85). However, at the low end of the rectal temperature scale, ear temperatures tended to be higher, and at the high end of the rectal temperature scale, ear temperatures tended to be lower. There were 292 readings with a rectal temperature 38.0°C and in 204 (70%) the ear temperature was also 38.0°C. A retrospective analysis of 53 children who became febrile in hospital (ear or rectal temperature 38.0°C) showed that fever was detected first by rectal measurement in seven, by ear measurement in 31 (59%), and by both in 15 (28%). These data indicate that, on the average, rectal and ear temperature measurements are not different. Fever that developed in children after hospitalization was more likely to be first detected by ear than by rectal measurement.

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