Noninvasive measurement of body temperature in critically ill patients.

Elizabeth Bridges is an assistant professor at the University of Washington School of Nursing, a clinical nurse researcher at the University of Washington Medical Center in Seattle, and is director of Deployed Combat Casualty Research Team CJTF101 in Afghanistan. Karen Thomas, is a professor at the University of Washington School of Nursing. invasive methods (PA, esopha geal, or bladder), the following methods should be used in this order: rectal, oral, and tympanic. Axillary, temporal artery, and chemical dot thermometers are not recommended. In a subsequent series of letters to the editor, the author stated that temporal artery measurements were not recommended because Lawson et al found that 20% of the temporal artery temperature measurements were greater than ±0.5°C different from the concurrent PA temperature. However, as summarized in Table 1, the bias and precision of the oral and temporal artery methods were similar, and 19% of the oral measurements were also greater than ±0.5°C different from the concurrent PA temperature, suggesting that the 2 methods are comparable. Similarly, Fetzer and Lawrence recently compared ear-based and temporal artery temperature measurements and reported that the bias between the 2 methods was -0.4±0.64°C (95% CI, -1.29 to 1.21), which is less accurate and precise than either method compared with PA temperature measurement (Table 1). Unlike the studies outlined in Table 1, the difference between the ear-based and temporal artery methods reflects the error in both measurements, and we cannot say AElizabeth Bridges, RN, PhD, CCNS, and Karen Thomas, RN, PhD, reply: