Body temperature measurement in paediatrics: Which gadget should we believe?
Bibliographic record
Abstract
any decisions regarding the investigation and treatmentof paediatric patients are determined by body temper-ature. In the 21st century, we still struggle to find a quickand convenient method that parents and health care workerscan use to measure body temperature accurately.The goal of measuring body temperature is to approxi-mate the core temperature, which is the temperature of theblood that bathes the temperature-regulating centre in thehypothalamus. However, there is a gradient between everybody site where temperature can be measured and the hypo-thalamus. Contrary to popular dogma, this gradient is notconstant (ie, rectal temperature is not reliably 1°C higherthan axillary temperature). Therefore, it is difficult tochoose a body site to use as the reference standard for com-paring readings obtained by different instruments or at dif-ferent sites.The following sites have been used in studies of bodytemperature measurement in children:• Pulmonary artery (PA):This site is vascular, and it isanatomically relatively close to the hypothalamus. Inadults, PA readings are only 0.18°C lower thanreadings from blood returning from the brain in thehigh internal jugular vein (1). PA catheters are usuallyonly placed in children during cardiac surgery, but thisremains the best site to use as the reference standardfor core temperature in studies comparingmeasurements taken from other body sites and withdifferent instruments.• Distal esophagus:This site is easily accessible insedated patients, and readings in paediatric patients arecloser to PA readings than are rectal, axillary, bladderor tympanic readings (2). Therefore, this site is a goodchoice for temperature measurement in sedatedpatients or for use as a reference standard when PA readings are not practical. • Rectal: Although used as the reference standard inmany previous studies, the rectum is a long distancefrom the hypothalamus. Decreased splanchnic flow canresult in falsely low readings and rectal temperature isslow to respond to changes in core temperature,especially if stool is present in the lower rectum (2,3).There is often reluctance on the part of parents andolder children to measure rectal temperature, andnosocomial infections have been attributed to the useof rectal thermometers in hospital (4). There are rarecase reports of rectal perforation caused by rectalthermometers in neonates and the safety of doingrectal temperatures in neutropenic patients has notbeen established. • Bladder: Urinary catheters with thermistors areavailable, but the results of studies are disparate as towhether bladder temperatures are closer to PA readingsthan rectal temperatures (2,5). Readings may be falselylow if urine output is decreased.• Nasopharyngeal: In the only paediatric study (5) todate that compared nasopharyngeal temperature withother sites, mean difference from PA temperature was0.43°C, which was higher than the difference forbladder temperatures, but lower than the difference forrectal, tympanic or axillary temperatures. Induction ofnasopharyngeal bleeding is a potential risk. • Axillary: To obtain an accurate reading, thethermometer probe must be placed over the axillaryartery, which is a great challenge in children. Localcooling (‘drawdown’) can occur from placement of thethermometer in a neonate (6). Axillary readings areexpected to be lower than readings from other sites,and this appears to be the case with all types ofthermometers (7). For all these reasons, fever is oftennot detected by axillary readings.• Tympanic: Tympanic temperatures were initiallymeasured with a probe applied directly to the tympanicmembrane and were found to closely approximate thetemperature in the circle of Willis (8). Infraredthermometers were then developed, and readings canbe obtained within a few seconds by blindly directingthe tip of the instrument toward the tympanicmembrane. Readings are not affected by cerumin or
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".