Exergen LXTA-5000, Reference Manual

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Guidelines for Patient Temperature Assessment
Guidelines for Patient Temperature Assessment
1 11 1 1..... FFFFFeeeeevvvvver Def er Def er Def er Def er Definition: inition: inition: inition: inition: Clinically, fever is defined as a BT =1.8°F (1°C) above the mean standard
deviation at the site of recording.
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A single oral temperature of 101°F (38.3°C ) in the absence
of obvious environmental causes is usually considered fever. An oral temperature of 100.4°F
(38.0°C ) over at least 1 hour indicates a fever state. 3
2. 2. 2. 2. 2. Oral T Oral T Oral T Oral T Oral Tem em em em emperature Risks: perature Risks: perature Risks: perature Risks: perature Risks: Oral temperature can be clinically misleading, and many febrile pa-
tients can have a “normal” temperature, even when tachypnea was unobserved.
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3. 3.
3. 3. 3. R
R
R R Rectal T
ectal T
ectal T ectal T ectal Tem
em
em em emperature Risks:
perature Risks:
perature Risks: perature Risks: perature Risks: Rectal temperature should only be considered as a good approxi-
mation of core temperature when the patient’s thermal balance is stable. When monitored
during or after surgery, rectal temperature measurement is not suitable, and the possible delay
in diagnosis of a thermal abnormality could lead to an irreversible crisis.
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4. 4.
4. 4. 4. Axillar
Axillar
Axillar Axillar Axillary T
y T
y T y T y Tem
em
em em emperature Risks:
perature Risks:
perature Risks: perature Risks: perature Risks: Axillary temperature is contraindicated in critically ill adults, and
its use in the general patient population should be discouraged due to its unreliable correlation
with core temperature and its poor reproducibility.
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5. 5.
5. 5. 5. TTTTTem
em
em em emporal Ar
poral Ar
poral Ar poral Ar poral Arttttter
er
er er ery T
y T
y T y T y Tem
em
em em emperature (T
perature (T
perature (T perature (T perature (TAAAAAT) V
T) V
T) V T) V T) Values:
alues:
alues: alues: alues: On a stable resting patient, TAT is ~0.8°F ( 0.4°C)
higher than an optimum oral temperature, and close to a rectal temperature.
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However, during
febrile episodes, the difference can be much higher, mainly because of the artifacts of oral and
rectal sites.
Note: If your temporal artery thermometer is marked Arterial
Oral
,
it is programmed to compute the normal
average cooling effect at the mouth, and automatically reduces the higher arterial temperature by that amount.
This allows existing protocols based on oral temperature to be maintained, and results in a reading consistent
with the mean normal oral temperature of 98.6ºF (37ºC) .
6. 6. 6. 6. 6. Com Com Com Com Comparison Be parison Be parison Be parison Be parison Betw tw tw tw tween Sit een Sit een Sit een Sit een Sites: es: es: es: es: Review of published literature reveals mean differences between
non-TA sites of 0.4° to 3.1°F (0.2° to 1.7°C) with actual differences of up to 6.5°F (3.6°C )
routinely reported, especially in febrile patients.
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References:
1
Kuzucu EY. Measurement of temperature. Int Anesthesiol Clin, 3(3):435-49, May, 1965
2
El-Radhi AS, Carroll JE. Fever in Paediatric Practice, Ch 2, pp 15-49, Oxford Blackwell Scientific Publications,
1994
3 Hughes WT et al. 1997 Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained
fever. Infectious Diseases Society of America (IDSA)
4 Tandberg D et al. Effect of tachypnea on the estimation of body temperature by an oral thermometer. NE J Med ,
308, 945-46,1983
5
O’Grady NP, Barie PS, Bartlett JG, et al. Practice guidelines for evaluating new fever in critically ill adult patients.
Task Force of the Society of Critical Care Medicine and the Infectious Diseases Society of America. Clin Infect Dis
1998 May: 26(5):1042-59
6
Houdas Y, et al. Human body temperature. Ch 5, p89 Plenum Press, 1982, USA, UK
7
Exergen Corporation. Manufacturer’s data on file.
8 Review of subject material peer-reviewed journals.