Infrared thermometers and infants: The device is hot the baby maybe not.

Abstract

AIM\nThe risk of serious illness in febrile infants (<60\u2009days old) is high, and so fever often warrants aggressive management. Infrared thermometers are unreliable in young infants despite their ubiquity. We aim to describe the: (i) frequency of infrared thermometer usage; (ii) progression to documented fever in the emergency department (ED) and (iii) rate of serious illness (meningitis, urinary tract infection and bacteremia).\n\n\nMETHODS\nIn this single-centre retrospective chart review at The Royal Children s Hospital, Melbourne, we audited medical records of infants (<60\u2009days old) presenting to the ED with pre-hospital fever on history over a 12-month period. We described the type of thermometer used at home (tympanic or forehead, infrared vs. axillary or rectal, direct ) correlated to peak temperature in ED, investigations, treatment and diagnosis. The primary outcome was subsequent fever in ED.\n\n\nRESULTS\nOf 159 infants, two of three had infrared temperature measurement at home. Fifty-one (32.1%) developed fever in ED (direct 28/54, 52% vs. infrared 23/105, 22% RR 2.36 (95% CI 1.52-3.69)). Investigations (75%) and admission (60%) were common. Pre-hospital fever alone was less likely to be associated with serious illness, with fever in ED a much stronger predictor.\n\n\nCONCLUSIONS\nIn young infants, infrared thermometer use is common and less likely to predict subsequent fever. Twenty-two percent of infants with fever via infrared measurement had fever in ED. History of fever without confirmation is less likely to signal serious illness. Education to public and health-care providers is required to avoid usage of infrared devices in this population.