The accuracy of body temperature measurement is particularly important in the following situations: fever in neutropenic children with cancer is frequently caused by bacterial infection, which is among the leading causes of death in these patients. Admission to hospital and administration of antibiotics are often based on the presence of fever alone. Children with sickle-cell anaemia are particularly susceptible to overwhelming bacterial infections, and detection of fever commonly has similar implications as with neutropenic febrile children. As epilepsy is defined by recurrent non-febrile seizures, the only outward difference between a febrile and an epileptic seizure at the onset of the seizure is the presence of fever in the febrile seizure. Since investigation, treatment and the prognosis of children with febrile seizure and epilepsy are different, measurement of body temperature is of paramount importance.
An ideal thermometer should accurately reflect core body temperature, be convenient and easy to use, give rapid results, not result in cross infection, not be influenced by ambient temperature, be cost-effective and finally possess high reproducibility. Despite advanced techniques, none of the temperature measurement devices meet all the above criteria. The chapter describes the best available thermometers that should be used in practice.
In neonates, body temperature is recommended to be measured in the axilla; in older children in the ear. There is a consensus that axillary temperature measurement is primarily useful in neonates. Rectal temperature measurement is not favoured by parents and nurses. This method is contraindicated in neutropenic oncology patients. The oral temperature measurement is not used in children less than 5 years of age, and this is the group with the highest incidence of fever. Ear measurement appears to be the most suitable. However, evidence confirming the accuracy of the infrared ear-based thermometer is incomplete.
Core temperature Ideal thermometers History of thermometers Evidence-based temperature measurement
This is a preview of subscription content, log in to check access.
Sarton G. Sarton on the history of science. Cambridge, MA: Harvard University Press; 1962.CrossRefGoogle Scholar
Musher DM, Dominguez EA, Bar-Sela A. Edouard Seguin and the social power of thermometry. N Engl J Med. 1987;316:115–7.CrossRefGoogle Scholar
Webb GE. Comparison of oesophageal and tympanic membrane monitoring during cardiopulmonary bypass. Anesth Analg. 1973;52:729–33.PubMedGoogle Scholar
Lilly JK, Boland JP, Zekan S. Urinary bladder temperature monitoring: a new index of body core temperature. Crit Care Med. 1980;8:742–4.CrossRefGoogle Scholar
Baskin MN, O’Rourke EJ, Fleisher GR. Outpatient treatment of febrile infants b28 to 89 days of age with intramuscular administration of ceftriaxone. J Pediatr. 1992;120:22–7.CrossRefGoogle Scholar
El-Radhi AS, Jawad MH, Mansor N, et al. Sepsis and hypothermia in the newborn infant: value of gastric aspirate examination. J Pediatr. 1983;103:300–2.CrossRefGoogle Scholar
Miller G, Stein F, Trevino R, et al. Rectal-scalp temperature difference predicts brain death in children. Pediatr Neurol. 1999;20:267–9.CrossRefGoogle Scholar
El-Radhi AS, Carroll J. Fever in paediatric practice. Hoboken: Blackwell Publishing; 1994. p. 68–84.Google Scholar
Bergeson PS, Steinfeld HJ. How dependable is palpation as screening method for fever. Clin Pediatr. 1974;13:350–1.CrossRefGoogle Scholar
Banco L, Veltri D. Ability of mothers to subjectively assess the presence of fever in their children. Am J Dis Child. 1984;138:976–8.PubMedGoogle Scholar
Morley CJ, Hewson PH, Thornton AJ, et al. Axillary and rectal temperature measurements in infants. Arch Dis Child. 1992;67:122–5.CrossRefGoogle Scholar
Brooks S, Khan A, Stoica D, et al. Reduction of vancomycin-resistant enterococcus and clostridium difficile infections following change to tympanic thermometers. Infect Control Hosp Epidemiol. 1998;19:333–6.CrossRefGoogle Scholar
El-Radhi AS. Determining fever in children: the search for an ideal thermometer. Br J Nurs. 2014;23(2):91–4.CrossRefGoogle Scholar
Silverman BG, Daley WR, Rubin JD. The use of infrared ear thermometers in pediatric and family practice offices. Public Health Rep. 1998;113:268–72.PubMedPubMedCentralGoogle Scholar
El-Radhi AS, Patel S. Temperature measurement in children with cancer: an evaluation. Br J Nurs. 2007;16:1313–6.CrossRefGoogle Scholar