1342 Screening Patients’ Temperature in COVID-era Outpatient Clinics: An Overreliance on Unreliable Devices?

Aim The Covid-19 pandemic continues to impair patient access to hospital clinics. One way of enabling outpatient services to continue safely is to screen for pyrexia by checking patients’ temperature prior to their clinic appointment. Infrared tympanic thermometers (ITT) are commonly used as a surrogate marker of core temperature. Non-contact infrared cutaneous thermometers (NICT) are increasingly favoured as they require no direct contact with patients. The aim was to measure the concordance of temperature readings between ITT and NICT on patients attending ENT outpatient clinic at one hospital. Method Body temperature was recorded using ITT and NICT on 63 sequential patients. Agreement was tested using a Bland-Altman plot with 95% confidence interval and paired T-tests. Results Mean body temperature was significantly lower (p < 0.05) for the NICT [36.3 °C (95% CI 36.2 °C-36.4 °C)] compared with the ITT [36.6 °C (95% CI 36.5 °C-36.7 °C)]. The NICT measured on average 0.34 °C (95% CI 0.33 °C-0.35 °C) lower than the ITT. The Bland-Altman plot showed moderate agreement of the two methods (SD 0.46 °C; limits -1.25 °c to 0.57 °c); however, disagreement was greater at higher and lower temperature extremes. Conclusions Screening patients for pyrexia aims to help prevent spread of COVID-19. False negatives result in a missed opportunity to break the chain of transmission. A significant proportion of false negatives may reverse any intended benefit. NICT are convenient but may be more susceptible to false negatives when assessing for pyrexia and may provide little more than false reassurance when used for pyrexia screening.