No-touch Forehead Temperature Measurement in Two Clinical Settings

Background. Healthcare personnel prefer devices that maximize efficiency while minimizing cross-contamination as well as cost. The Caregiver® (Thermomedics, Inc., Miami. FL), a new infrared non-contact forehead thermometer has been developed for clinical professional use. Our objective was to evaluate the clinical accuracy and repeatability of the Caregiver as compared to measurements obtained with an oral electronic thermometer in a family clinic and an out-patient pediatric clinic.
Methods. In a prospective fashion with patients acting as their own controls, patient care staff took repeated temperatures in two outpatient settings with the Caregiver and with an electronic predictive thermometer, the SureTemp™ (Welch-Allyn, Skaneateles, NY) used either orally or in the axilla. Reference measurements were oral in the family clinic and axillary in the pediatric clinic.

Results. In the sample of all ages, clinical accuracy (bias) was 0.04±0.67°F and repeatability 0.2°F. In the pediatric sample, Caregiver temperatures were higher than axillary by 0.25±0.75°F in all but infants where there was almost no difference (0.04±0.47°F).

Conclusions. Clinical bias in both adult and pediatric patients was very good at 0.25°F or better. Clinical variability (Standard Deviation) was comparable to those of other studies using predictive oral or axillary temperatures as a reference. Clinical repeatability of the Caregiver was very good at 0.2°F for adults and 0.35°F for pediatric patients. Since the Caregiver uses an orally-referenced algorithm, average axillary readings in all but infants were lower than Caregiver readings by 0.25°F. Otherwise, average Caregiver readings were almost the same as oral temperatures.

Introduction
Caregiver is a non-invasive clinical professional thermometer that reads human body temperature without touch in children and adults by detecting the body`s infrared energy. It does so with a fast and  simple one-button operation that minimizes cross-contamination.

Our  objective   was   to   evaluate   the   device   by comparing temperature measurements obtained with the  Caregiver to measurements obtained with a predictive oral electronic thermometer in a clinic setting.

The Careaiver measurements were taken in the "BODY" mode which incorporates an algorithm that adjusts the reading to an equivalent sublingual oral temperature.

Methods
We asked the patient care staff of a busy family practice clinic and an outpatient pediatric unit to obtain successive temperature measurements using the Caregiver thermometer and their own SureTemp thermometers normally in use in each setting. Patients had temperatures measured with both devices as a part of regular patient care. To obtain Caregiver temperatures, operators simply aimed the device at the middle of the patient`s forehead from 1 to 3 inches away, pressed the button, waited momentarily for a tone to indicate the temperature had been obtained and then recorded the readina. They then obtained one oral or axillary reading using their standard method. Some Caregiver readings were done in triplicate in order to determine repeatability. Of the remainder, the majority were done twice, while about 16 sets of readings consisted of a single Caregiver and a single SureTemp reading. Age, gender and time of day were also recorded. After completion of all data collection in the respective locations, patient care staff provided feedback on a user preference survey. All temperatures were taken and are shown in degrees Fahrenheit for maximum resolution.