Thursday, February 20, 2014

TAT for Fever Assessment in Gigante

Fever is one of the most common presenting complaints in any paediatric setting. Nicaraguan 
parents generally know when their child has fever, based on touch, and in Canada, the majority of families have a thermometer or an electronic device to measure temperature. 

The days of the traditional mercury thermometer are long gone. Whenever a thermometer broke, tiny beads of toxic mercury spread out along the floor and entered our environment. In our digital era, there are a variety of non-toxic electronic options.
Annie using TAT to assess for fever. 
The newest electronic method to assess temperatures is the Temporal Artery Thermometer (TAT). Dave Bateman RN, Nurse Manager at the Prostate Cancer Centre in Calgary, Alberta, Canada, donated a TAT for the Gigante clinic. Thank you Dave!!

Over my career I have witnessed a variety of "new" methods and devices to measure temperature. Some have come, not stood the test of time, and disappeared. TAT is new to me. As such, I reviewed the medical literature on the subject.

The TAT has only been around for a few years. I identified seven citations published since 2010 that compare TAT to oral, rectal, or "core" temperatures. The TAT compared favourably in each article.  

A December 2012 article in the Journal of Clinical Anaesthesia compared TAT to oral temperatures in sixty children under anaesthesia at 15, 30, 45, 60, 90 and 120 minutes. There was no statistical difference.

An April 2010 article in the Journal of PeriAnesthesia Nursing compared TAT with esophageal (core) temperature in 23 children. TAT was only 0.074 degrees centigrade higher than the core temperature, and well within the 4% margin considered acceptable in the modern clinical world. 

The data to date suggest TAT is reliable. The device is certainly simple and non-invasive. I requested that every temperature be measured at least twice to confirm within-individual reliability and so far the results have been good.

Thank you Dave Bateman at the Prostate Cancer Centre in Calgary. Much appreciated!!!! 

References
Sahin SH et al. Comparison of temporal artery, nasopharyngeal, and axillary temperature measurement during anesthesia in children. J Clin Anesthesia 2012;24:647-51.

Calonder EM et al. Temperature Measurement in Patients Undergoing Colorectal and Gynecology Surgery: A Comparison of Esophageal Core, Temporal Artery, and Oral Methods. J PeriAnesthesia Nursing. 2010;25:71-8.


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