Therefore, the purpose of our systematic review was to assess the existing evidence about the validity of using oral temperature to measure core body temperature at periods of rest and changing body temperature. 6, 7 The continued use of oral temperature in the clinical setting may be based on scientific evidence however, a systematic review allows the congregate analysis of all peer-reviewed articles on the subject, strengthening the consensus about whether oral temperature is a valid measure of core body temperature. Despite these scientific findings, many medical professionals continue to prefer and use oral temperature for body temperature measurement, particularly in the athletic training setting. The results were unfavorable for the use of oral temperature as an accurate measurement of core body temperature. In several clinical trials, researchers 1–3, 8–15 have compared rectal and oral temperatures in both resting and exercising participants. 14, 15 With the continued incidence of EHS and the emergence of exertional sickling as a cause of sudden death, ATs and other medical professionals must be aware of the proper way to assess elevated core body temperature to make a correct diagnosis and proper treatment selection because these conditions have distinctly opposing treatment protocols. Unfortunately, many EHS cases are undiagnosed and inappropriately treated initially because of the use of inaccurate temperature sites, such as the mouth, auditory canal, and axilla. 6 This finding is alarming considering that an accurate measurement of core body temperature is essential for determining proper treatment. 6, 7 The surveyed ATs recognized rectal temperature as the criterion standard and as the body site recommended by the NATA for assessment however, many cited its impracticality, their lack of training, and invasiveness as reasons not to use this method. Based on these investigations, we found that ATs prefer to use oral temperature as a method of core body temperature assessment when evaluating athletes whom they suspect have hyperthermia or EHS. In addition, we tried to identify the rationale for their choices in clinical practice when assessing the magnitude of exercise-induced hyperthermia. 1–3, 6–13 In 2 recent studies,6,7 we attempted to identify the preferences of high school and college athletic trainers (ATs) for using different core body temperature sites. Any reliance on oral temperature in an emergency, such as exertional heat stroke, might grossly underestimate temperature and delay proper diagnosis and treatment.Īlthough their efficacy in measuring core body temperature is debated, 1–3 oral temperature measurements are popular in many clinical settings. Oral temperature cannot accurately reflect core body temperature, probably because it is influenced by factors such as ambient air temperature, probe placement, and ingestion of fluids. In addition, the differences were greatest at the highest rectal temperatures. The difference was −0.50☌ ± 0.31☌ at rest and −0.58☌ ± 0.75☌ during a nonsteady state.Ĭonclusions: Evidence suggests that, regardless of whether the assessment is recorded at rest or during periods of changing core temperature, oral temperature is an unsuitable diagnostic tool for determining body temperature because many measures demonstrated differences greater than the predetermined validity threshold of 0.27☌ (0.5☏). A critical review of these studies indicated a disparity between oral and criterion standard temperature methods (eg, rectal and esophageal) specifically as the temperature increased. All 16 were included in the review because they met the minimal PEDro score of 4 points (of 10 possible points), with all but 2 scoring 5 points. Sixteen studies met the inclusion criteria and subsequently were evaluated by 2 independent reviewers. The search was limited to articles focusing on temperature readings and studies involving human participants.ĭata Synthesis: Original research was reviewed using the Physiotherapy Evidence Database (PEDro). Controlled vocabulary was used, when available, as well as key words and variations of those key words. Objective: To critically evaluate original research addressing the validity of using oral temperature as a measurement of core body temperature during periods of rest and changing core temperature.ĭata Sources: In July 2010, we searched the electronic databases PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Academic Search Premier, and the Cochrane Library for the following concepts: core body temperature, oral, and thermometers. However, many clinicians, including athletic trainers, use it rather than criterion standard methods, such as rectal thermometry. Context: Oral temperature might not be a valid method to assess core body temperature.
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