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Accuracy of Tympanic Temperature Measurement in Firefighters Completing a Simulated Structural Firefighting Task

Published online by Cambridge University Press:  01 September 2015

Toby Keene*
Affiliation:
Australian Capital Territory Ambulance Service, Quality, Safety, and Risk Unit, Canberra, Australia Australian Catholic University, Queensland, Australia
Matt Brearley
Affiliation:
National Critical Care and Trauma Response Centre, Disaster Medicine Research, Darwin, Australia
Beth Bowen
Affiliation:
Australian Capital Territory Ambulance Service, Quality, Safety, and Risk Unit, Canberra, Australia
Anthony Walker
Affiliation:
Australian Capital Territory Fire and Rescue, Department of Justice and Community Safety, Canberra, Australia UC Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
*
Correspondence: Toby Keene, MPH Clinical Quality Assurance Officer ACT Ambulance Service 9 Amberley Avenue Fairbairn, ACT, 2609 GPO Box 158 Canberra City, ACT, 2601 E-mail: [email protected]

Abstract

Introduction

In the course of their duties, firefighters risk heat stroke and other medical conditions due to exertion in high-temperature environments. Infrared tympanic temperature measurement (TTym) is often used by Emergency Medical Services (EMS) to assess the core body temperature of firefighters. The accuracy of TTym in this setting has been called into question.

Hypothesis/Problem

This study aimed to examine the accuracy of TTym for core body temperature assessment at emergency firefighting events compared with gastrointestinal temperature measurement (TGI) as measured by ingestible thermometers.

Methods

Forty-five (42 male, three female) professional urban firefighters from an Australian fire service completed two 20-minute work periods in a 100°C (± 5°C) heat chamber while wearing personal protective clothing (PPC) and breathing apparatus (weighing approximately 22 kg). Measurements were taken immediately before entering, and on exiting, the heat chamber. Tympanic temperature was assessed by an infrared tympanic thermometer and TGI was measured by ingestible sensor and radio receiver.

Results

Complete data were available for 37 participants. Participant temperatures were higher on exiting the heat chamber than at baseline (TTym: 35.9°C (SD=0.7) vs 37.5°C (SD=0.8); TGI: 37.2°C (SD=0.4) vs 38.6°C (SD=0.5)). Tympanic temperature underestimated TGI on average by 1.3°C (SD=0.5) before entering the chamber and by 1.0°C (SD=0.8) following the exercise. Using pooled data, the average underestimation was 1.2°C (SD=0.7).

Conclusion

Tympanic thermometers cause an unreliable measure of core body temperature for firefighters engaged in fire suppression activities. Accurate and practical measures of core body temperature are required urgently.

KeeneT , BrearleyM , BowenB , WalkerA . Accuracy of Tympanic Temperature Measurement in Firefighters Completing a Simulated Structural Firefighting Task. Prehosp Disaster Med. 2015;30(5):461–465.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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References

1. Barr, D, Gregson, W, Reilly, T. The thermal ergonomics of firefighting reviewed. Appl Ergon. 2010;41(1):161-172.Google Scholar
2. Walker, A, Driller, M, Argus, C, Cooke, J, Rattray, B. The aging Australian firefighter: an argument for age-based recruitment and fitness standards for urban fire services. Ergonomics. 2014;57(4):612-621.Google Scholar
3. Cheung, S, Petersen, S, McLellan, T. Physiological strain and countermeasures with firefighting. Scand J Med Sci Sports. 2010;20(s.3):103-116.Google Scholar
4. Cheung, SS, McLellan, TM, Tenaglia, S. The thermophysiology of uncompensable heat stress. Sports Med. 2000;29(5):329-359.CrossRefGoogle ScholarPubMed
5. Hostler, D, Suyama, J, Guyette, FX, et al. A randomized controlled trial of aspirin and exertional heat stress activation of platelets in firefighters during exertion in thermal protective clothing. Prehosp Emerg Care. 2014;18(3):359-367.Google Scholar
6. Smith, D, Petruzzello, S, Chludzinski, M, Reed, J, Woods, J. Selected hormonal and immunological responses to strenuous live-fire firefighting drills. Ergonomics. 2005;48(1):55-65.Google Scholar
7. Smith, DL, Petruzzello, SJ, Goldstein, E, et al. Effect of live-fire training drills on firefighters' platelet number and function. Prehosp Emerg Care. 2011;15(2):233-239.Google Scholar
8. Walker, A, Driller, M, Brearley, M, Argus, C, Rattray, B. Cold-water immersion and iced-slush ingestion are effective at cooling firefighters following a simulated search and rescue task in a hot environment. Appl Physiol Nutr Metab. 2014;39(10):1159-1166.Google Scholar
9. Wright-Beatty, HE, McLellan, TM, Larose, J, Sigal, RJ, Boulay, P, Kenny, GP. Inflammatory responses of older firefighters to intermittent exercise in the heat. Eur J Appl Physiol. 2014;114(6):1163-1174.Google Scholar
10. Zeller, L, Novack, V, Barski, L, Jotkowitz, A, Almog, Y. Exertional heatstroke: clinical characteristics, diagnostic and therapeutic considerations. Eur J Intern Med. 2011;22(3):296-299.Google Scholar
11. Casa, DJ, Becker, SM, Ganio, MS, et al. Validity of devices that assess body temperature during outdoor exercise in the heat. J Athl Train. 2007;42(3):333.Google Scholar
12. Gant, N, Atkinson, G, Williams, C. The validity and reliability of intestinal temperature during intermittent running. Med Sci Sports Exerc. 2006;38(11):1926-1931.Google Scholar
13. Amoateng-Adjepong, Y, Del Mundo, J, Manthous, CA. Accuracy of an infrared tympanic thermometer. Chest. 1999;115(4):1002-1005.Google Scholar
14. Christensen, H, Boysen, G. Acceptable agreement between tympanic and rectal temperature in acute stroke patients. Int J Clin Pract. 2002;56(2):82-84.Google Scholar
15. Gagnon, D, Lemire, BB, Jay, O, Kenny, GP. Aural canal, esophageal, and rectal temperatures during exertional heat stress and the subsequent recovery period. J Athl Train. 2010;45(2):157.Google Scholar
16. Ganio, MS, Brown, CM, Casa, DJ, et al. Validity and reliability of devices that assess body temperature during indoor exercise in the heat. J Athl Train. 2009;44(2):124.Google Scholar
17. Hostler, D, Bednez, JC, Kerin, S, et al. Comparison of rehydration regimens for rehabilitation of firefighters performing heavy exercise in thermal protective clothing: a report from the Fireground Rehab Evaluation (FIRE) trial. Prehosp Emerg Care. 2010;14(2):194-201.Google Scholar
18. Kong, PW, Beauchamp, G, Suyama, J, Hostler, D. Effect of fatigue and hypohydration on gait characteristics during treadmill exercise in the heat while wearing firefighter thermal protective clothing. Gait Posture. 2010;31(2):284-288.Google Scholar
19. Hostler, D, Reis, SE, Bednez, JC, Kerin, S, Suyama, J. Comparison of active cooling devices with passive cooling for rehabilitation of firefighters performing exercise in thermal protective clothing: a report from the Fireground Rehab Evaluation (FIRE) trial. Prehosp Emerg Care. 2010;14(3):300-309.Google Scholar
20. Brearley, M, Norton, I, Trewin, T, Mitchell, C. Fire Fighter Cooling in Tropical Field Conditions. Darwin, Australia: National Critical Care and Trauma Response Centre; 2011.Google Scholar
21. R Core Team. R: A Language and Environment for Statistical Computing 3.0.3 (2014-03-06) ed. Vienna, Austria: R Foundation for Statistical Computing; 2014.Google Scholar
22. Bland, JM, Altman, D. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327(8476):307-310.Google Scholar
23. Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Int J Nurs Stud. 2010;47(8):931-936.Google Scholar
24. Bland, JM, Altman, DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17(4):571-582.Google Scholar
25. Brearley, MB, Heaney, MF, Norton, IN. Physiological responses of medical team members to a simulated emergency in tropical field conditions. Prehosp Disaster Med. 2013;28(2):139-144.Google Scholar
26. Pryor, RR, Seitz, JR, Morley, J, et al. Estimating core temperature with external devices after exertional heat stress in thermal protective clothing. Prehosp Emerg Care. 2011;16(1):136-141.Google Scholar
27. Langridge, P, Ruzic, A, Larsen, B, Lord, C, Aisbett, B. “Assessing the validity of tympanic temperature to predict core temperature of firefighters in different environmental conditions.” In: Thorton RP, Wright LJ, (eds). Proceedings of Bushfire CRC & AFAC 2012 Conference Research Forum. Vol 28. Perth, Australia: Bushfire CRC; 2012: 150-159.Google Scholar
28. Daanen, H. Infrared tympanic temperature and ear canal morphology. J Med Eng Technol. 2006;30(4):224-234.Google Scholar
29. Muir, I, Bishop, P, Lomax, R, Green, J. Prediction of rectal temperature from ear canal temperature. Ergonomics. 2001;44(11):962-972.Google Scholar
30. Sato, KT, Kane, NL, Soos, G, Gisolfi, CV, Kondo, N, Sato, K. Reexamination of tympanic membrane temperature as a core temperature. J Appl Physiol. 1996;80(4):1233-1239.Google Scholar
31. Yamakoshi, T, Matsumura, K, Rolfe, P, Tanaka, N, Yamakoshi, Y, Takahashi, K. A novel method to detect heat illness under severe conditions by monitoring tympanic temperature. Aviat Space Environ Med. 2013;84(7):692-700.Google Scholar