The pacifier thermometer. Comparison of supralingual with rectal temperatures in infants and young children
S. Press and B. J. Quinn
Department of Pediatrics, University of Miami School of Medicine, Fla, USA.
OBJECTIVE: To determine the correlation between supralingual temperatures
obtained with a new electronic pacifier thermometer (Steridyne) and rectal
temperatures obtained with a digital electronic thermometer. DESIGN:
Prospective study. SETTING: Pediatric emergency department and pediatric
inpatient ward of a tertiary university hospital. PARTICIPANTS: Convenience
sample of 100 patients, aged 7 days to 24 months. MAIN OUTCOME MEASURES: A
supralingual and rectal temperature were obtained for each patient. For the
first 30 patients, the time needed for the pacifier thermometer to signal a
final, steady-state reading was recorded. RESULTS: The mean +/- SD
difference between rectal temperatures and supralingual temperatures
adjusted upward by 0.5 degree F was -0.01 degree F +/- 0.42 degree F
(statistically zero) (95% confidence interval, -0.09 degree F to 0.07
degree F). The correlation coefficient between supralingual and rectal
temperatures was 0.95. Sensitivity and specificity of the pacifier
thermometer for detecting fever (temperature > or = 100.4 degrees F
[> or = 38.0 degrees C]) was 72.0% and 98.0%, respectively (positive
predictive value, 97.3%; negative predictive value, 77.8%). Increasing
supralingual temperatures by 0.5 degree F increased sensitivity to 92.0%,
and decreased specificity to 76.0% (positive predictive value, 79.3%;
negative predictive value, 90.5%). It took an average time of 3 minutes 23
seconds for the pacifier thermometer to display a steady-state temperature.
CONCLUSIONS: The pacifier thermometer evaluated here was found to be an
accurate means of temperature measurement when recorded temperatures were
adjusted upward by 0.5 degree F. The approximate 3 minutes required for a
final temperature determination makes the pacifier thermometer most
appropriate for use in low-volume ambulatory care settings and in the home.
Further investigation of this device is recommended.
