Evaluation of body temperature measurements of the tympanic, forehead and neck

Aim: The aim of this study is to investigate the reliability of the most commonly used body temperature region and method in the emergency department. For this reason, the tympanic body temperature value, which gives values close to the body core temperature, and the forehead temperature and carotid artery skin temperature values will be compared and it will be investigated which one gives a closer result to the tympanic value. Material and Method: The population of the research consists of individuals between the ages of 18-65 who applied to the Tokat Gaziosmanpaşa University Training and Research Hospital Emergency Service between February and March 2021. The sample of the study consisted of 502 patients who met the inclusion criteria and accepted to participate in the study. The personal data of the patients were recorded in the 'Patient Identification Form' and the measurement data were recorded in the 'Patient Observation Form'. Tympanic measurements; Measured with 'Braun ThermoScan 7 IRT 6520'. Forehead and neck carotid artery temperatures were measured with the 'Braun No touch+touch thermometer BNT400B'. Ambient temperature and humidity were recorded with Baby&Plus heat and humidity meter. Body temperatures of the same patient were first measured with a tympanic thermometer by the same and one investigator. Afterwards, forehead temperature and carotid artery skin temperature measurements were made. Measurements in all patients; made over the left ear, middle forehead and left neck carotid artery. In all measurements, 2-3 times measurements were made until the measurement result was fixed, and the constant value was recorded. Data were analyzed with the MedCalc V20.110 program release version. Repeated Analysis of Variance was used to compare tympanic temperature, neck carotid artery skin temperature, and forehead temperature, and multiple comparisons were analyzed with the Bonferroni test. Bland-Altman method and Intraclass Correlation Coefficient were used to examine the correlation between tympanic temperature and neck and forehead temperature. The difference of mean differences from zero was examined with the One-Sample T-Test. Significance level was taken as p<0.050. Results: The mean tympanic temperature, forehead temperature, and neck carotid artery skin temperature were found to be 37.30°C, 36.67°C and 36.99°C, respectively. A statistically significant difference was found between the mean values of tympanic, forehead and carotid artery skin temperatures (p<0.001). According to the Bland-Altman method; The mean of the difference between the tympanic temperature and forehead temperature values was 0.633, and the mean difference was found to be statistically significant from 0 (p<0.001). While the lower limit of agreement was -0.454, the upper limit of agreement was 1.719, and a statistically significant moderate agreement was obtained between tympanic temperature and forehead temperature (ICC=0.726; p<0.001). The mean of the difference in temperature values obtained from the tympanic temperature and neck carotid artery skin temperature methods was 0.309, and the mean of this difference was found to be statistically significant from 0 (p<0.001). While the lower limit of agreement was -0.606, the upper limit of agreement was 1.223, and a statistically significant good agreement was obtained between the tympanic temperature and the skin temperature of the Neck Carotid Artery (ICC=0.807;p<0.001). Conclusion: Average Forehead temperature is lower than average Neck Carotid Artery Skin temperature. While there was a moderately significant agreement between forehead and tympanic temperatures, a good agreement was obtained between Neck Carotid Artery skin temperature and Tympanic temperature. Neck Carotid Artery skin temperature is an area that can be used for patient evaluation in the emergency room setting. In critical patient follow-up, evaluation should be made together with other regions. Keywords: Emergency Service, Thermometer, Forehead Temperature, Tympanic Temperature, Carotid Artery Skin Temperature.