Journal article
Emergency department rectal temperatures in over 10 years: A retrospective observational study
World journal of emergency medicine, Vol.4(2), pp.107-112
2013
DOI: 10.5847/wjem.j.issn.1920-8642.2013.02.004
PMID: 25215102
Abstract
Fever in patients can provide an important clue to the etiology of a patient's symptoms. Non-invasive temperature sites (oral, axillary, temporal) may be insensitive due to a variety of factors. This has not been well studied in adult emergency department patients. To determine whether emergency department triage temperatures detected fever adequately when compared to a rectal temperature.
A retrospective chart review was made of 27 130 adult patients in a high volume, urban emergency department over an eight-year period who received first a non-rectal triage temperature and then a subsequent rectal temperature.
The mean difference in temperatures between the initial temperature and the rectal temperature was 1.3 °F (P<0.001), with 25.9% of the patients having higher rectal temperatures ≥2 °F, and 5.0% having higher rectal temperatures ≥4 °F. The mean difference among the patients who received oral, axillary, and temporal temperatures was 1.2 °F (P<0.001), 1.8 °F (P<0.001), and 1.2 °F (P<0.001) respectively. About 18.1% of the patients were initially afebrile and found to be febrile by rectal temperature, with an average difference of 2.5 °F (P<0.001). These patients had a higher rate of admission (61.4%, P<0.005), and were more likely to be admitted to the hospital for a higher level of care, such as an intensive care unit, when compared with the full cohort (12.5% vs. 5.8%, P<0.005).
There are significant differences between rectal temperatures and non-invasive triage temperatures in this emergency department cohort. In almost one in five patients, fever was missed by triage temperature.
Details
- Title: Subtitle
- Emergency department rectal temperatures in over 10 years: A retrospective observational study
- Creators
- Graham A Walker - Department of Emergency Medicine, Kaiser Permanente, San Francisco, USADaniel Runde - Department of Emergency Medicine, University of California, Los Angeles, USADaniel M Rolston - Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, USADan Wiener - Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, USAJarone Lee - Massachusetts General Hospital, Harvard Medical School, South Boston, MA 02127, USA
- Resource Type
- Journal article
- Publication Details
- World journal of emergency medicine, Vol.4(2), pp.107-112
- Publisher
- China
- DOI
- 10.5847/wjem.j.issn.1920-8642.2013.02.004
- PMID
- 25215102
- ISSN
- 1920-8642
- Language
- English
- Date published
- 2013
- Academic Unit
- Emergency Medicine
- Record Identifier
- 9984025281702771
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