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Tuesday, August 06, 2013
Let's talk about temporal artery thermometers

A temporal artery thermometer (TAT) is a portable, noninvasive, painless device that measures temporal artery blood temperature by scanning the overlying skin surface with infrared technology. As the scanning wand is firmly swept against the skin surface, it accurately measures both the temporal arterial blood temperature and the skin surface temperature. This process is called arterial heat-loss balance. Each second the wand remains in contact with the skin, it records 1,000 temperatures per second. It combines the average of these recordings, and the TAT software processes the result on a digital LED display in the form of a number. TATs are very efficient, providing results within an average of 6 seconds.

AGE, ACCURACY, AND AVAILABILITY

TATs can be used on all age groups, from newborns to geriatric patient populations. Medical grade TATs cost an average of $500 dollars, but less expensive in-home alternatives are available at most pharmacies and large retail stores. Although they can be utilized on newborns, new research has shown that TATs are slightly less reliable in infants less than age 3 months when compared with rectal temperature measurement. According to the manufacturers, TATs recognize changes in temperature quicker than axillary, oral, or rectal methods. However, unlike rectal thermometers, TATs cause no physical discomfort and can be utilized on a sleeping child without waking him or her.

To obtain an accurate reading, ensure that your patient’s skin surface is dry and intact before scanning. If perspiration or tears are present on the skin surface, it will result in a false low reading. Also, if your patient has been exposed to cold external environments, wait at least 15 minutes to allow his or her skin surface to acclimate. This will prevent a false low reading. TATs are routinely utilized in EDs, by home healthcare nurses, in physicians’ offices, and on long-term care and hospice units. Growing in popularity, TATs are now found in approximately 60% of all healthcare facilities nationwide. The general consensus to date is that TATs are accurate and painless tools to obtain temperatures.

LET’S TAKE A LOOK

The TAT is a lightweight, wand-like device that fits easily in one hand. It has a curved scanning tip sensor that’s gently moved snugly against the skin to obtain an accurate temperature. Most TATs are made of medical-grade plastic or stainless steel. TATs use an infrared scanner to measure the temperature of the temporal artery. The temporal artery begins in the forehead and runs parallel to the front of the ear, where it branches into the superficial temporal artery behind the ear and the carotid artery in the neck. The TAT captures heat that’s naturally released from the skin over the temporal artery. Because arteries receive blood directly from the heart, this is a good option for detecting core temperature without being invasive.

In healthcare settings, thin, disposable, single use, latex-free scanning probe covers can be used. Utilizing disposable probe covers reduces the risk of hospital-acquired infections. Even when disposable probe covers are used, you should ensure that the TAT is thoroughly cleansed between patients to reduce the likelihood of cross contamination. When cleansing the TAT, follow your healthcare facility’s policy and the manufacturer’s cleaning instructions. Most TATs are maintained in an electrical docking station to keep the battery of the device powered at all times. Some versions of the TAT can also use either a replaceable or rechargeable 9 volt battery to provide power.

DIRECTIONS FOR THIS DEVICE

Follow these directions when using a TAT to take a patient’s temperature:

Provide privacy and explain to your patient and his or her caregiver (if necessary) that you need to assess his or her body temperature. Providing privacy will allow the patient or caregivers to ask any questions they have about the procedure.

If the patient is a child, allow him or her to see and touch the TAT. This will usually engage the child and reduce any anxiety he or she may be experiencing.

Inspect the patient’s forehead and neck to ensure that there’s no visible perspiration present. Perspiration can cause a false low result.

Wash your hands and don gloves.

Visually inspect the TAT device to ensure that it’s clean and in working order.

Apply a disposable probe cover to the scanning tip if your facility uses them.

The TAT can be used in either the sitting or lying position. However, ideally your patient will be in a sitting position to reduce your risk of a back strain injury.

Firmly press the “scan” button.

Apply the scanning tip sensor gently across your patient’s forehead, behind the ear, and down the neck in one slow, fluid movement, ensuring that the scanning sensor remains in contact with the skin for a minimum of 6 seconds to obtain an accurate reading.

A digital reading will appear with the temperature result on the display window.

Discard the disposable probe cover in the waste basket.

Cleanse the TAT scanning wand and sensor per your facility’s policy and the manufacturer’s instructions.

Place the TAT back in its proper storage place so that other nurses can access it if needed.

Discard your gloves and wash your hands.

Record the temperature result in your patient’s medical record.

If your patient’s temperature is low or elevated, inform the healthcare team immediately.

The TAT is a painless and cost-effective tool you can utilize to accurately and quickly (within 6 seconds) assess temperature in patients of all ages in outpatient or inpatient settings. Talk with your healthcare team to see if a TAT would be a beneficial addition to your work area

References

Carleton E, Fry B, Mulligan A, Bell A, Brossart C. Temporal artery thermometer use in the pre-hospital setting. CJEM. 2012;14(1):7-13.

Carrigan J. How do temporal artery thermometers measure up? http://www.nursinglibrary.org/vhl/handle/10755/162372.

Jefferies S, Weatherall M, Young P, Beasley R. A systematic review of the accuracy of peripheral thermometry in estimating core temperatures among febrile critically ill patients. Crit Care Resusc. 2011;13(3):194-199.

Penning C, van der Linden JH, Tibboel D, Evenhuis HM. Is the temporal artery thermometer a reliable instrument for detecting fever in children? J Clin Nurs. 2011;20(11-12):1632-1639.

 

By Denise Landon, BSN, RN, CMSC

Direct Care Nurse • VA Outpatient Clinic • Clarkesville, Tenn.

 

Melinda Dickens, LPN, SN

LPN • Alvin C. York VA Medical Center • Murfreesboro, Tenn.

 

Charlotte Davis, BSN, RN CCRN

CCU/CVICU Direct Care Nurse • Heritage Medical Center • Shelbyville, Tenn.

Direct Care Nurse/Charge Nurse • Alvin C. York VA Medical Center • Murfreesboro, Tenn.

About the Author

NursingMadeIncrediblyEasy
The mission of the peer-reviewed journal Nursing made Incredibly Easy! is to meet the ongoing educational needs of nurses in a refreshingly original, easily understood format.

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