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Be wary in using ear thermometer

The feature on fever in a returning traveller (Clinical, June 7) raises a number of questions. The illustration shows the use of an infrared ear thermometer. There are two distinct problems associated with their use. 

In order for the device to produce a satisfactory reading it must be inserted fairly firmly into the external ear canal. This is quite uncomfortable in adults and may be distressing for children. 

The second problem is the accuracy and reliability of the readings. In my experience readings cannot be regarded as reliable. When I last used one of these devices a few years ago I was concerned to find a series of 'normal' readings in children who seemed quite flushed and hot. Subsequent checking with a conventional thermometer in the groin or axilla confirmed raised temperatures in all of them.

Unless a good view of the tympanic membrane is obtained these devices can read inaccurately. The presence of a digital display suggests a precision in measurement that is entirely spurious.

One of our local hospitals abandoned the use of these devices a few years ago for similar reasons to those I have outlined. I would treat any reading taken with one as highly speculative.

Dr Michael Blackmore

Ringwood, Hampshire

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