Accuracy of infrared ear thermometry and other temperature methods in adults

1994 ◽  
Vol 3 (1) ◽  
pp. 40-54 ◽  
Author(s):  
RS Erickson ◽  
LT Meyer
Keyword(s):  
Critical Care ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
High Variability ◽  
External Factors ◽  
University Teaching ◽  
Convenience Sample ◽  
Critical Care Units ◽  
Bladder Temperature ◽  
Pulmonary Artery Catheters

OBJECTIVE: To compare the accuracy of infrared ear-based temperature measurement in relation to thermometer, ear position, and other temperature methods, with pulmonary artery temperature as the reference. METHODS: Ear-based temperature measurements were made with four infrared thermometers, three in the core mode and two in the unadjusted mode, each with tug and no-tug techniques. Pulmonary artery, bladder (n = 21), and axillary temperatures were read after each ear-based measurement and oral temperature was measured once when possible (n = 32). Subjects consisted of a convenience sample of 50 patients with pulmonary artery catheters who were in adult critical care units of a university teaching hospital. RESULTS: Ear-based measurements correlated well with pulmonary artery temperature (r = .87 to .91), although closeness of agreement differed among thermometer-mode combinations (mean offsets = -0.7 to 0.5 degree C) and had moderately high variability between subjects (SD = +/- 0.5 degree C) with all instruments. Use of an ear tug either made no difference or resulted in slightly lower readings. Bladder temperature was nearly identical to pulmonary artery temperature values (r = .99, offset = 0.0 +/- 0.2 degree C). Oral readings were slightly lower (r = .78, offset = -0.2 degree C) and axillary readings much more so (r = .80 to .82, offset = -0.7 degree C); both were highly variable (SD = +/- 0.6 degree C) and affected by external factors. CONCLUSIONS: Infrared ear thermometry is useful for clinical temperature measurement as long as moderately high variability between patients is acceptable. Readings differ among thermometers, although several instruments provide values close to pulmonary artery temperature in adults. Readings are not higher with an ear tug. Bladder temperature substitutes well for pulmonary artery temperature, whereas oral and axillary values may be influenced by external factors in the critical care setting.

Needs of Patients’ Family Members in an Intensive Care Unit With Continuous Visitation

2016 ◽  
Vol 25 (2) ◽  
pp. 118-125 ◽  
Author(s):  
Mini Jacob ◽  
Cynthia Horton ◽  
Sharon Rance-Ashley ◽  
Tera Field ◽  
Robbie Patterson ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Rank Order ◽  
Family Members ◽  
Continuous Family ◽  
Convenience Sample ◽  
Critical Care Units ◽  
Level Of Satisfaction ◽  
National Organizations ◽  
High Level

BackgroundAlthough many critical care experts and national organizations support open visitation in intensive care units (ICUs), most ICU visiting policies do not allow unrestricted presence of patients’ family members.ObjectiveTo describe how well the needs of family members were met in an adult neuroscience ICU with a continuous visitation policy and an adjoining private suite for patients’ family members.MethodsAn exploratory, descriptive study design was used to identify the effects of continuous family visitation in the neuroscience ICU on patients’ family members and their needs and experiences during their time in the unit. A convenience sample of consenting family members completed a survey of family need items 72 hours after the patient was admitted to the unit.ResultsThe most important needs identified by the 45 family members surveyed were items relating to information about the patient, visiting the patient, being given hope, talking with a doctor each day, and being assured that the best care is being given to the patient. Least important items were related to physical comforts for the family members. The vast majority of family members rated their needs as being met for all of the items in the survey and reported a high level of satisfaction with care.ConclusionIn a neuroscience ICU with an open visitation policy and a private suite for patients’ family members, family members rated their needs as being met at a high level, unlike in prior studies in units with limitations on family visitation. The rank order of the importance of each need in the survey was similar to rankings in prior studies in a variety of critical care units.

Temporal Scanner Thermometry: A New Method of Core Temperature Estimation in ICU Patients

2005 ◽  
Vol 50 (1) ◽  
pp. 15-18 ◽  
Author(s):  
D Myny ◽  
J De Waele ◽  
T Defloor ◽  
S Blot ◽  
F Colardyn
Keyword(s):  
Temporal Artery ◽  
Mean Difference ◽  
University Teaching ◽  
Vasopressor Therapy ◽  
Good Reliability ◽  
Temperature Estimation ◽  
Convenience Sample ◽  
Icu Patients ◽  
Vasoactive Medication ◽  
Pulmonary Artery Catheters

Background and Aims: Temperature measurement is a routine task of patient care, with considerable clinical impact, especially in the ICU. This study was conducted to evaluate the accuracy and variability of the Temporal Artery Thermometer (TAT) in ICU-patients. Therefore, a convenience sample of 57 adult patients, with indwelling pulmonary artery catheters (PAC) in a 40-bed intensive care unit in a university teaching hospital was used. Methods: The study design was a prospective, descriptive comparative analysis. Body temperature was thereby measured simultaneously with the TAT and the Axillary Thermometer (AT), and was compared with the temperature recording of the PAC. The use of vasoactive medication was recorded. Results and conclusions: Mean temperature of all measurements was: PAC: 37.1°C (SD: 0.87), TAT: 37.0°C (SD: 0.68) and axillary thermometer: 36.6°C (SD: 0.94). The measurements of the TAT and the PAC were not significantly different (mean difference: 0.14°C; SD: 0.51; p= 0.33); whereas the measurements of the PAC and the AT differed significantly (mean difference: 0.46°C; SD: 0.39; p< 0.001). Mean difference in PAC versus TAT analyses, between patients with vasopressor therapy (0.12°C; SD: 0.55), and without vasopressor therapy (0.19°C; SD: 0.48) was not statistically significant (p= 0.47). Conclusion: We can conclude that the temporal scanner has a relatively good reliability with an acceptable accuracy and variability in patients with normothermia. The results are comparable to those of the AT, but they do not seem to be sufficient to prove any substantial benefit compared to rectal, oral or bladder thermometry.

The Incremental Cost Effectiveness of Withdrawing Pulmonary Artery Catheters from Routine Use in Critical Care

2005 ◽  
Vol 4 (4) ◽  
pp. 257-264 ◽  
Author(s):  
Katherine Stevens ◽  
Christopher McCabe ◽  
Carys Jones ◽  
Joanne Ashcroft ◽  
Sheila Harvey ◽  
...  
Keyword(s):  
Critical Care ◽  
Cost Effectiveness ◽  
Pulmonary Artery ◽  
Incremental Cost ◽  
Pulmonary Artery Catheters

The Pulmonary Artery (Swan-Ganz) Catheter: Evaluation of A Hemodynamic Monitoring Device in Critical Care Medicine

1993 ◽  
Vol 9 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Giuseppe Pagliarello
Keyword(s):  
Critical Care ◽  
Pulmonary Artery ◽  
Patient Care ◽  
Hemodynamic Monitoring ◽  
Scientific Evidence ◽  
Care Physician ◽  
Monitoring Device ◽  
Medical Monitoring ◽  
Critical Care Units ◽  
The Impact

AbstractThe pulmonary artery catheter (PAC) is an invasive hemodynamic monitoring device that is used extensively in critical care units. This technological advance allows the critical care physician and nurse to closely monitor physiological functions at the bedside. There have been no formal evaluations of the impact of this device on patient care. Reviews and observational studies have yielded different conclusions regarding risks and benefits to patients. This has resulted in much editorial comment expressing divergent opinions on the value of the PAC, but there has been no scientific evidence to guide practice and no apparent effect on the use of these devices. The PAC and other medical monitoring devices must be evaluated with respect to their impact on patient care.

Temperature Measurement in Critical Care Adults: A Comparison of Thermometry and Measurement Routes

2004 ◽  
Vol 6 (2) ◽  
pp. 117-125 ◽  
Author(s):  
Linda S. Smith
Keyword(s):  
Critical Care ◽  
Temperature Measurement ◽  
Fiber Optic ◽  
Temperature Monitoring ◽  
Temperature Sensing ◽  
Monitoring Device ◽  
Convenience Sample ◽  
Difference Scores ◽  
Temperature Levels ◽  
Mean Differences

Purpose. To describe within- and between-subject mean differences between and among temperature sites (oral, axilla, PA) and instruments. Methods. A convenience sample (N = 35) of volunteering, adult (18 years), 1st-day postcardiac surgery inpatients was obtained. Temperature-sensing instruments included Geratherm DataTherm and SolarTherm, and Abbott Opticath fiber optic PA catheters. For 21 min, simultaneous temperature readings (°C) at 4 temperature sites with 3 thermometry devices were monitored. Results. Mean difference at 21 min PA and between DataTherm axilla and PA = 0.72°C (SD 0.30); between PA and SolarTherm oral = 0.62°C (SD 0.34); and between PA and SolarTherm axilla = 0.46°C (SD 0.16). Temperature levels were not a factor relative to difference scores between study and reference devices. Conclusions. Both test devices, SolarTherm (an intermittent-use device) and DataTherm (a temperature-monitoring device), performed well, and correlated strongly with PA temperature assesments.

Use of Peripherally Inserted Central Catheters As an Alternative to Central Catheters in Neurocritical Care Units

2011 ◽  
Vol 31 (2) ◽  
pp. 70-75 ◽  
Author(s):  
Christi DeLemos ◽  
Judy Abi-Nader ◽  
Paul T. Akins
Keyword(s):  
Critical Care ◽  
Subarachnoid Hemorrhage ◽  
Pulmonary Artery ◽  
Neurocritical Care ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Pulmonary Artery Catheters ◽  
Central Catheters ◽  
Neurological Critical Care

Background Patients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an alternative to central venous catheters in neurocritical care settings. Methods Data on 35 patients who had peripherally inserted central catheters rather than central venous or pulmonary artery catheters for intravascular access and monitoring were collected from a prospective registry of neurological critical care admissions. These data were cross-referenced with information from hospital-based data registries for peripherally inserted central catheters and subarachnoid hemorrhage. Results Complete data were available on 33 patients with Hunt-Hess grade IV–V aneurysmal subarachnoid hemorrhage. Catheters remained in place a total of 649 days (mean, 19 days; range, 4–64 days). One patient (3%) had deep vein thrombosis in an upper extremity. In 2 patients, central venous pressure measured with a peripherally inserted catheter was higher than pressure measured concurrently with a central venous catheter. None of the 33 patients had a central catheter bloodstream infection or persistent insertion-related complications. Conclusions Use of peripherally inserted central catheters rather than central venous catheters or pulmonary artery catheters in the neurocritical care unit reduced procedural and infection risk without compromising patient management.

Monitoring Urinary Bladder Temperature in the Intensive Care Unit: State of the Science

2002 ◽  
Vol 11 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Wendy M. Fallis
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Body Temperature ◽  
Urinary Bladder ◽  
Urinary Flow ◽  
Critical Care Units ◽  
Bladder Temperature ◽  
Continuous Drainage ◽  
Alternative Sites ◽  
State Of The Science

Body temperature of patients in critical care units can be monitored with a variety of devices and at a variety of body sites. In recent years, monitoring of urinary bladder temperature has become more common. Temperature-sensing indwelling urinary catheters allow continuous drainage of urine and continuous measurement of body temperature. This article provides a comprehensive and critical review of research undertaken in intensive care units to compare body temperatures measured in the urinary bladder with temperatures measured at a core site, the pulmonary artery. The studies support the use of urinary bladder temperature as a reliable index of core temperature during times of thermal stability. For critically ill patients who are already under considerable stress and whose condition necessitates the use of an indwelling urinary catheter, bladder temperature monitoring is an easy and convenient method that eliminates the need to use alternative sites. Further studies on the effects of shivering and urinary flow rate on temperatures measured in the bladder in critical care patients are needed. The economics of monitoring urinary bladder temperature also should be studied.

Critical care nurses' knowledge of pulmonary artery catheters

1996 ◽  
Vol 5 (1) ◽  
pp. 49-54 ◽  
Author(s):  
D Burns ◽  
D Burns ◽  
M Shively
Keyword(s):  
Critical Care ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Educational Background ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Nursing Experience ◽  
Pulmonary Artery Catheters ◽  
Care Nursing ◽  
Nurses Knowledge

BACKGROUND: Earlier studies indicate that nurses and physicians have a knowledge deficit regarding pulmonary artery catheters. OBJECTIVE: To evaluate critical care nurses' knowledge of pulmonary artery catheters. METHODS: A 31-item, multiple-choice questionnaire was administered to 168 critical care nurses from institutions in a southern California metropolitan area. Fourteen demographic questions were included to determine variables such as critical care nursing experience, educational background, work area, and frequency of pulmonary artery catheter use that may have affected participants' scores. The investigators traveled to the institutions to explain and conduct the study. RESULTS: The mean knowledge score was 16.4 of 29 questions (56.8% items correct), with a standard deviation of 3.74. The range of correct scores was 8 to 25. Two questions were not factored into the statistical analysis because they were specific to the physician's role in pulmonary artery catheter insertion. The variables that correlated with higher scores were CCRN certification, attendance at a pulmonary artery catheter class, years of critical care experience, and frequent use of the pulmonary artery catheter. Of the respondents, 39% were unable to identify a pulmonary artery wedge measurement value from a waveform recording. CONCLUSIONS: Critical care nurses' knowledge of pulmonary artery catheters is related directly to the frequency of their exposure to it, critical care nursing experience, attendance at a pulmonary artery catheter class, and CCRN certification. Additional research is needed on a larger scale to validate these findings and determine if critical care nurses' knowledge of pulmonary artery catheters is sufficient to maintain quality standards of safety and optimal patient care.

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