EXERGEN
TemporalScanner
A kinder, gentler way to take temperatureA kinder, gentler way to take temperature
A kinder, gentler way to take temperature
A kinder, gentler way to take temperatureA kinder, gentler way to take temperature
TM
1
Models LXTA/TAT-5000 and TAT-4000
Reference Manual
Product Map
Product Map
Probe Cone
Probe Lens
ON Button
Automatic turn-off
in 15 seconds
LED Display Screen
Battery Compartment
Battery Compartment Door
Compartment Door Screw
9-volt battery
9-Volt Battery
2
Introduction to Temporal Artery Thermometry
Introduction
The MeThe Me
The Me
The MeThe Me
Temporal artery thermometry (TAT) is a completely new method of temperature assessment,
using infrared technology to detect the heat naturally emitting from the skin surface. In addi-
tion, and of key importance, the method incorporates a patented arterial heat balance system
to automatically account for the effects of ambient temperature on the skin.
This method of temperature assessment has been shown to improve results and reduce costs
by non-invasively measuring body temperature with a degree of clinical accuracy unachievable
with any other thermometry method.
Temperatures are more reliable than with other methods. Fevers are identified sooner. Treat-
ment can be initiated sooner. We trust you will find temporal artery thermometry is simply a
better method.
WhWh
Wh
WhWh
The TAT method was developed in response to the clinical requirements for a truly non-inva-
thodthod
thod
thodthod
y the Ty the T
y the T
y the Ty the T
emem
poral Arporal Ar
em
poral Ar
emem
poral Arporal Ar
tt
erer
yy
t
er
y
tt
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sive, accurate method of thermometry. Oral thermometry is subject to many artifactual errors;
rectal temperature meets with strong resistance from patients, parents, and even many clini-
cians. Ear thermometers, although convenient, are sensitive to technique. Some brands are
known to miss fevers, and it’s difficult to consider the use of an aural thermometer when 95%
of pediatric visits concern ear infections.
A site for detecting fevers with roots dating back to centuries before Christ, the temporal artery
demonstrated the necessary requirements to meet the stringent demands of clinical medicine
today: it is easily accessible, contains no mucous membranes, and notably, maintains a rela-
tively constant perfusion rate, ensuring the stability of blood flow required for the measure-
ment method.
As a site for temperature measurement, the temporal artery presents many benefits: it poses
no risk of injury for patient or clinician, eliminates any need for disrobing or unbundling, and is
suitable for all ages.
3
Table of Contents
Page(s)
Product Map 2
Table of Contents
Introduction to Temporal Artery Thermometry 3
Familiarize Yourself with the TemporalScanner 5-6
Using the Instrument 7
Using the Instrument on a New Mother 8
Using the Instrument on an Infant 9
Frequently Asked Questions 10-13
Disposable Cover Options 13
Accessories 13
Guidelines for Patient Temperature Assessment
Comparing with other methods of thermometry 14-15
Determining a Fever Threshold 16
Body Sites for Temperature Assessment
An overview of temperature measuring sites 17-18
Reproducibility in Temperature Measurement 19
Forgotten Physiology 20-21
For Kids Only 22
Care and Maintenance of the Instrument 21-25
4
Before Using, Familiarize Yourself with the Instrument
TT
o Scano Scan
•
T
o Scan: Depress the red button. The instrument will continually scan for the highest temperature
TT
o Scano Scan
(peak) as long as the button is depressed.
Clicking: Clicking:
•
Clicking: Each click indicates a rise to a higher temperature, similar to a radar detector.
Clicking: Clicking:
TT
o Ro R
ee
•
•
•
The Scan
tain or Lock Rtain or Lock R
T
o R
e
tain or Lock R
TT
o Ro R
ee
tain or Lock Rtain or Lock R
pressed, and will lock on display for 15 seconds on the LXTA/TAT-5000, or 30 seconds on the TAT-4000
after button is released. If measuring room temperature with the TAT-4000, the temperature will remain
on the display for only 5 seconds.
TT
o Ro R
estarestar
T
o R
TT
o Ro R
thermometer will immediately begin a new scan each time the button is depressed.
Pulse Timer: Pulse Timer:
Pulse Timer: The thermometer has a built-in pulse timer.
Pulse Timer: Pulse Timer:
t: t:
estar
t: Depress the button to restart. It is not necessary to wait until the display is clear, the
estarestar
t: t:
eading:eading:
eading: The reading will remain on the display as long as the red button is de-
eading:eading:
LXTA/TAT-5000: To activate, press the red button once and release. The display will
remain on for fifteen seconds.
TAT-4000: To activate, you should touch something >90ºF(32ºC) (skin) , press the
red button once and release. The display will remain on for 30 seconds.
Familiarize yourself with the Instrument
One of the most important features of the TAT thermometer is its ability to scan. It is a patented feature of the
instrument. Scanning is critical in obtaining the correct temperature, since there are temperature gradients
present not only inside the body, but across the entire surface of the body.
The object of scanning is to capture the highest temperature, the peak, in the area being scanned. As
long as the button is depressed, the thermometer will be continually sampling and recording the highest
temperature it measures.
Test it first on your hand to get comfortable with the concept.
Depress the red button, and keep it depressed. Scan the probe over the center area of your palm,
keeping the probe about a half an inch off the surface to avoid cooling the skin.
LXTA/TAT-5000: Watch the display as the temperature increases in synchrony with the clicking. When
the numbers on the display stop increasing, the clicking also stops, indicating that the
peak temperature has been reached.
TAT-4000 The display will flash SCAN, and there will be a soft but rapid clicking sound each time the
sensor detects a temperature higher than the one before. When the flashing and
clicking slow to about 1 per second, the peak temperature has been reached.
Any of the above indications can be used to assure the peak temperature has been reached. Notice on
the LXTA/TAT-5000 that the temperature only increases over the initial measurement. Once a peak has
been measured, it is locked on the display , and will not change until a higher temperature has been
measured.
Remove the instrument from your palm, release the button and note the reading on the display.
The reading will be locked on the display for 15 seconds on the LXTA/TAT-5000, and 30 seconds on the TAT4000, unless you press the button again before that time. Repeat the above steps and you should get the
same, or very close to the same number, since your hand will usually not appreciably change temperature
very quickly.
5
Practice Holding Your TemporalScanner
The TemporalScanner is ergonomically designed specifically for
its application. It’s best to hold the instrument with your thumb
on the red button, much like you would hold a remote control.
Along with allowing you to easily read the temperature display, you
will automatically be using finger dexterity to gently position the
probe, providing comfort and safety for your patient and consis-
tently accurate temperature readings.
Things To Know Before Taking Temperatures
• Measure only the exposed side. Anything covering the area
to be measured would insulate it and prevent the heat from
dissipating, resulting in falsely high readings. Brush hair aside
if covering the TA, or the area behind the ear.
• Slide the thermometer straight across the forehead (midline),
Familiarize Yourself with the Instrument
and not down the side of the face. Midline over the TA area,
the TA is less than 2mm below skin surface, whereas as the
TA winds down the side of the face it is further from the skin
surface. Although anatomically correct, sliding downwards
could result in falsely low readings.
• It is preferable to hold the instrument sideways, as illustrated
in Figure 2. Approaching your patient with the instrument
straight up and down could be somewhat intimidating.
• When making the measurement behind the ear as in Figure
3, tuck the thermometer under the ear lobe in the soft coni-
cal depression on the neck just below the mastoid. This is
the place where a dab of perfume is typically applied.
Using on an Infant
• An infant is apt to be presented bundled, with blankets and
clothing covering the neck area. Fortunately, the perfusion
rate is normally strong for infants, and unless visibly dia-
phoretic, one measurement at the TA is typically all that is
required.
Should you feel that the temperature is too low, push aside
any clothing or blankets covering the neck area for ~30
seconds or so and repeat the measurement behind the ear.
6
Basics of Using the TemporalScanner
Using the Temporal
Scanner
Measure only the eMeasure only the e
Measure only the e
Measure only the eMeasure only the e
Brush hair aside if coBrush hair aside if co
Brush hair aside if co
Brush hair aside if coBrush hair aside if co
TT
A areaA area
T
A area
TT
A areaA area
11
..
1
.With probe flush on the cen-
11
..
xposed sidexposed side
xposed side
xposed sidexposed side
vv
ering theering the
v
ering the
vv
ering theering the
ter of forehead, depress red
kk
button,
2.2.
SloSlo
2.
Slo
2.2.
SloSlo
wlywly
wly
wlywly
eep depressed…eep depressed…
k
eep depressed…
kk
eep depressed…eep depressed…
slide probe midline
across forehead to the hair line,
not down side of face.
AltAlt
ernaternat
e site sit
Alt
ernat
AltAlt
ernaternat
FF
emoral aremoral ar
•
F
emoral ar
FF
emoral aremoral ar
LatLat
eral thoracic areral thoracic ar
•
Lat
eral thoracic ar
LatLat
eral thoracic areral thoracic ar
area ˜midway between the axilla and the nipple
AxillaAxilla
•
Axilla: insert probe in apex of axilla for 2-3 seconds
AxillaAxilla
es when Tes when T
e sit
es when T
e site sit
es when Tes when T
tt
erer
t
er
tt
erer
Brush hair aBrush hair a
Brush hair a
Brush hair aBrush hair a
3.3.
3. Lift probe from forehead
3.3.
ww
w
ww
aa
a
aa
and touch on the neck just
behind the ear lobe.
4.4.
4. Release the button, read,
4.4.
and record temperature.
A or BE are unaA or BE are una
A or BE are una
A or BE are unaA or BE are una
yy
y: slowly slide the probe across groin
yy
tt
erer
yy
t
er
y: slowly scan side-to-side in the
tt
erer
yy
vv
ailable:ailable:
v
ailable:
vv
ailable:ailable:
y if coy if co
y if co
y if coy if co
vv
ering earering ear
v
ering ear
vv
ering earering ear
Questions? Please call us at 888-838-90Questions? Please call us at 888-838-90
Questions? Please call us at 888-838-90
Questions? Please call us at 888-838-90Questions? Please call us at 888-838-90
73 or 800-422-3006.73 or 800-422-3006.
73 or 800-422-3006.
73 or 800-422-3006.73 or 800-422-3006.
7
Using the TemporalScanner on a New Mother
Measure eMeasure e
•
Measure e
Measure eMeasure e
on a New Mother
KK
eep the red butteep the red butt
•
K
eep the red butt
KK
eep the red butteep the red butt
depressed thrdepressed thr
depressed thr
depressed thrdepressed thr
measurementmeasurement
measurement
Scanner
Using the Temporal
measurementmeasurement
(Brush bangs aside if present)(Brush bangs aside if present)
(Brush bangs aside if present)
(Brush bangs aside if present)(Brush bangs aside if present)
With prWith pr
1.
With pr
With prWith pr
SloSlo
2.
Slo
SloSlo
LifLif
Lif
LifLif
t prt pr
t pr
t prt pr
3.
(Brush hair a(Brush hair a
(Brush hair a
(Brush hair a(Brush hair a
xposed skinxposed skin
xposed skin
xposed skinxposed skin
onon
on
onon
oughoutoughout
oughout
oughoutoughout
obe flush on centobe flush on cent
obe flush on cent
obe flush on centobe flush on cent
wlywly
wly
wlywly
slide prslide pr
slide pr
slide prslide pr
obe frobe fr
obe fr
obe frobe fr
ww
w
ww
om fom f
om f
om fom f
aa
y if coy if co
a
y if co
aa
y if coy if co
obe acrobe acr
obe acr
obe acrobe acr
oss the foss the f
oss the f
oss the foss the f
oreheadorehead
orehead
oreheadorehead
vv
ering ear)ering ear)
v
ering ear)
vv
ering ear)ering ear)
er of fer of f
er of f
er of fer of f
orehead, depress red buttorehead, depress red butt
orehead, depress red butt
orehead, depress red buttorehead, depress red butt
orehead intorehead int
orehead int
orehead intorehead int
o the hair lineo the hair line
o the hair line
o the hair lineo the hair line
onon
on
onon
TT
ouch prouch pr
4.
T
ouch pr
TT
ouch prouch pr
RR
elease buttelease butt
5.
R
elease butt
RR
elease buttelease butt
••
• Temperature will remain on display for 15 seconds after the
••
red button is released.
••
• Sequence can be restarted at any time without waiting for
••
display to clear.
Questions? Please call us at 888-838-90Questions? Please call us at 888-838-90
Questions? Please call us at 888-838-90
Questions? Please call us at 888-838-90Questions? Please call us at 888-838-90
obe tobe t
obe t
obe tobe t
o neck just behind the ear lobeo neck just behind the ear lobe
o neck just behind the ear lobe
o neck just behind the ear lobeo neck just behind the ear lobe
on, read, and recoron, read, and recor
on, read, and recor
on, read, and recoron, read, and recor
d td t
emem
d t
d td t
peratureperature
em
perature
emem
peratureperature
73 or 800-422-3006.73 or 800-422-3006.
73 or 800-422-3006.
73 or 800-422-3006.73 or 800-422-3006.
8
Temping Baby in Bassinette, Open Crib, or with Mom
• Instrument should be in same environment as the baby.
• Measurement site must be exposed.
• One measurement, preferably at the TA, is all that is required.
Using the Temporal
Scanner
on an Infant
Preferred site is the temporal
artery area. In this case,
behind the ear could be an
alternate site, as both are
exposed.
TT
emem
perature at the Tperature at the T
T
em
perature at the T
TT
emem
perature at the Tperature at the T
1) Gently t1) Gently t
1) Gently t
1) Gently t1) Gently t
Depress red buttDepress red butt
♥
Depress red butt
Depress red buttDepress red butt
2) Slide pr2) Slide pr
2) Slide pr
2) Slide pr2) Slide pr
If more conIf more con
♥
If more con
If more conIf more con
of fof f
of f
of fof f
3) R3) R
3) R
3) R3) R
TT
emem
perature Behind the Earperature Behind the Ear
T
em
perature Behind the Ear
TT
emem
perature Behind the Earperature Behind the Ear
1) Gently nestle pr1) Gently nestle pr
1) Gently nestle pr
1) Gently nestle pr1) Gently nestle pr
elease buttelease butt
elease butt
elease buttelease butt
Depress red buttDepress red butt
♥
Depress red butt
Depress red buttDepress red butt
emem
em
emem
ouch prouch pr
ouch pr
ouch prouch pr
obe oobe o
obe o
obe oobe o
orehead.orehead.
orehead.
orehead.orehead.
poral Ar
v
vv
enient, slide frenient, slide fr
v
enient, slide fr
vv
enient, slide frenient, slide fr
on, remoon, remo
on, remo
on, remoon, remo
Temporal artery area is
the only option in this
case, as the neck area is
poral Arporal Ar
poral Arporal Ar
obe tobe t
obe t
obe tobe t
vv
er the Ter the T
er the T
vv
er the Ter the T
obe on neck behind the earobe on neck behind the ear
obe on neck behind the ear
obe on neck behind the earobe on neck behind the ear
tt
t
tt
o cento cent
o cent
o cento cent
on and kon and k
on and k
on and kon and k
A area intA area int
A area int
A area intA area int
vv
v
vv
on and kon and k
on and k
on and kon and k
erer
y Areay Area
er
y Area
erer
y Areay Area
er of fer of f
er of f
er of fer of f
eep depressed eep depressed
eep depressed
eep depressed eep depressed
om hairline tom hairline t
om hairline t
om hairline tom hairline t
e fre fr
om head, and recorom head, and recor
e fr
om head, and recor
e fre fr
om head, and recorom head, and recor
eep depressed.eep depressed.
eep depressed.
eep depressed.eep depressed.
orehead.orehead.
orehead.
orehead.orehead.
..
.
..
o hairline.o hairline.
o hairline.
o hairline.o hairline.
oo
ww
o
w
oo
ww
not exposed.
arar
ds centds cent
ar
ds cent
arar
ds centds cent
erer
er
erer
d.d.
d.
d.d.
..
.
..
Preferred
Site
Alternate
Site
2) Maintain skin contact until number2) Maintain skin contact until number
2) Maintain skin contact until number
2) Maintain skin contact until number2) Maintain skin contact until number
3) R3) R
3) R
3) R3) R
Questions? Please call us at 888-838-90Questions? Please call us at 888-838-90
Questions? Please call us at 888-838-90
Questions? Please call us at 888-838-90Questions? Please call us at 888-838-90
elease buttelease butt
elease butt
elease buttelease butt
on, remoon, remo
on, remo
on, remoon, remo
vv
e fre fr
om head, and recorom head, and recor
v
e fr
om head, and recor
vv
e fre fr
om head, and recorom head, and recor
73 or 800-422-3006.73 or 800-422-3006.
73 or 800-422-3006.
73 or 800-422-3006.73 or 800-422-3006.
9
s sts st
s st
s sts st
op.op.
op.
op.op.
d.d.
d.
d.d.
Frequently Asked Questions
What is the Temporal
The Temporal
invasive temperature assessment by scanning the temporal artery (TA).
technology
Scanner
.
Scanner
is an infrared thermometer designed for accurate, completely non-
?
It is breakthrough
How does it work?
Temperature is measured by gently stroking the Temporal
and includes a momentary touch of the probe to the neck area behind the ear lobe, to
account for any cooling of the forehead as a result of diaphoresis. The patented arterial
heat balance technology (AHB™) automatically measures the temperature of the skin sur-
Frequently Asked Questions
face over the artery and the ambient temperature. It samples and calculates these paired
readings some 1000 times a second to control for the effect of ambient temperature on
the skin, ultimately recording the highest temperature measured (peak) during the course
of the measurement. The Temporal
thermal radiation emitted from the skin.
Scanner
emits nothing - it only senses the natural
Scanner
across the forehead,
How accurate is it?
It has been clinically proven in premier university hospitals to be more accurate than ear
thermometry, and better tolerated than rectal thermometry. It is a superior method for
patient and clinician alike.
What if the TA area has been traumatized by burns or lacerations, or
is completely covered with dressings?
With head trauma, surgical or accidental, the temperature can be obtained from the
alternate site behind the ear lobe. As with diaphoresis, the perfusion will be high in the
presence of head trauma.
Why measure behind the ear lobe?
Sweat causes evaporative cooling of the skin on the forehead and introduces the possibility of a false low temperature. Fortunately for the method, during diaphoresis the area on
the head behind the ear lobe will always exhibit the high blood flow necessary for the
arterial measurement.
10
Why not use only the area behind the ear lobe?
Since the arterial branch is deeper behind the ear lobe than at the temple, under normal
conditions it is less accurate because of its variability. But under diaphoretic conditions, the
blood flow behind the ear lobe is as high as at the TA, making it as accurate as the TA,
only during diaphoresis or with head trauma as previously mentioned.
but
What are the benefits of using temporal artery thermometry?
Besides the inherent accuracy of the method, TAT presents no risk of injury for patient or
clinician, eliminates the need for disrobing or unbundling, and is suitable for all ages.
What is arterial temperature?
Arterial temperature is the same temperature as the blood flowing from the heart via the
pulmonary artery. It is the best determinate of body temperature and is unaffected by the
artifactual errors and time delays present with oral and rectal methods.
Frequently Asked Questions
How does the Temporal
Arterial temperature is close to rectal temperature, approximately 0.8°F (0.4ºC) higher than
oral temps. Expect larger differences at times, however, as the dynamics of thermoregulation favor the temporal artery method.
Scanner
compare to our old method?
High readings?
Temperatures measured with the Temporal
especially if you are used to oral or axillary temps. Oral and axillary temperatures can be
misleadingly lowered due to patient activity such as mouth breathing, drinking, tachypnea,
coughing, talking, etc., and periods of vasoconstriction during the fever process. Any or all of
these conditions may even mask fevers that the TemporalScanner will detect.
Scanner
may be higher than your current method,
Low readings?
A patient’s temperature measured with the Temporal
lower than oral temperature. Lower temperatures are usually from scanning too fast, not
keeping the button depressed, a dirty lens, or a sweaty forehead.
Scanner
is normally never appreciably
What else should I know?
False high readings:
• Measure only skin that is exposed to the environment. Any covering, hair, hat, bandages,
etc., will prevent the heat from dissipating, causing the reading to be falsely high.
11
False low readings:
• Multiple readings can cool the skin, so if you take another
measurement immediately, expect a slightly lower reading.
• Slide the thermometer straight across the forehead, not
down the side of the face where the TA could be embedded under cartilage or fat.
• Keep the probe flush on the skin, as in the picture on the
right. If angled, you will be measuring ambient air as well
as the TA area.
Frequently Asked Questions
Memorable solutions?
• Measure only the side exposed to the environment. The TemporalScanner assumes the skin it measures has equilibrated to ambient, so a down or covered side
could be falsely high as heat is trapped and the skin is unable to equilibrate.
• If the up side is not the side closest to you, try scanning
from
the hairline towards
the center of the forehead.
• Scan
Conditions that could affect a reading
slowly
across the TA area; if you scan too quickly you can miss the peak.
○○○○○○○○○○○○○○○○○○○○○○○○○○○
...and their solutions
• Bandages or pressure dressings covering the
forehead
• If accessible and dry, measure on
the area behind the ear lobe only.
• Forehead abrasions, burns, or sweat
• Agitated or combative patient
• Consider using the alternate sites:
femoral artery, lateral thoracic, or
• Patient’s forehead in direct draft from vent
axillary areas.
or fan
○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○
• Thermometer in different ambient temperature than patient, i.e. window ledge directly
exposed to hot sun or cold weather, or in
direct line of air conditioning or fan
12
• The Temporal
Scanner
should be kept
in the same ambient temperature as
your patient. Each 10° difference in
ambient can cause a 1° error in the
reading.
What should I know about the instrument
Frequently Asked Questions
• LXTA/TAT-5000 can be used with either
disposable probe cover, cap, or sheath.
Can be used without disposables if
terminally cleaned between patients.
• TAT-4000 requires disposables.
• Can be cleaned with any hospital ap-
proved disinfectant, alcohol, and even
bleach solutions.
• Double beeping indicates a low battery.
Replace with either a 9-volt alkaline or
9-volt lithium battery.
Disposable CoDisposable Co
Disposable Co
Disposable CoDisposable Co
(Model Illustrat(Model Illustrat
(Model Illustrat
(Model Illustrat(Model Illustrat
• Probe lens should be shiny clean. If not,
wipe with an alcohol prep or Q-tip
dipped in alcohol. Occasionally follow
with a damp wipe of water to remove
any alcohol residue buildup.
• A low or high reading outside body
temperature range is indicative of the
instrument’s failsafe mode, signifying a
mechanical failure.
• Single beeping indicates ambient or
target temperature outside limits.
• Can be used in either ºC or ºF.
vv
er Optionser Options
v
er Options
vv
er Optionser Options
ed: LXTed: LXT
ed: LXT
ed: LXTed: LXT
A/TA/T
A/T
A/TA/T
AA
TT
-5000)-5000)
A
T
-5000)
AA
TT
-5000)-5000)
No CoNo Co
vv
Patient
erer
v
er
vv
erer
No Co
No CoNo Co
Terminal
Cleaning at
No CoNo Co
vv
No Co
No CoNo Co
Disinfectant
Wipe Between
erer
v
er
vv
erer
Patients
Model LXTModel LXT
Model LXT
Model LXTModel LXT
PrPr
Pr
PrPr
Covers Entire
A/TA/T
A/T
A/TA/T
Accessories (Model Illustrated: TAT-4000)
1. Combination Unit
Part No. 134200
2. Instument Holder
(shown with security cable)
Part No. 134201
3. Cap Dispenser
Part No.134202
4. Disposable Caps
Part No. 134203
5. Security Cable
Part No. 124307
obe Wobe W
obe W
obe Wobe W
raprap
PrPr
rap
Pr
raprap
PrPr
Covers Entire
Probe
Model TModel T
Model T
Model TModel T
AA
TT
-5000 All Options-5000 All Options
A
T
-5000 All Options
AA
TT
-5000 All Options-5000 All Options
13
obe Capobe Cap
obe Cap
obe Capobe Cap
Probe
AA
A
AA
FF
ull Sheathull Sheath
F
ull Sheath
FF
ull Sheathull Sheath
Covers Entire
Instrument
TT
-4000 Options-4000 Options
T
-4000 Options
TT
-4000 Options-4000 Options
Guidelines for Patient Temperature Assessment
Arterial
97.4 -100.1°F
(36.3 - 37.8°C)
Oral
96.6 - 99.5ºF
(35.9 - 37.5°C)
Esophageal
98.4 -100.0ºF
(36.9 - 37.8°C)
Rectal
97.7 - 100.3ºF
(36.5 - 37.9°C)
Oronasal
96.6 - 99.0ºF
(35.9 - 37.2ºC)
Axillary
95.5 - 98.8°F
(35.3 - 37.1°C)
Comparing with Other Methods of Thermometry: Expect the Differences
Unless you are using PA catheters or Exergen aural thermometers with AHB for temperature assessment, expect to see differences compared to your current thermometers. Arterial temperature measurement leads all other methods in identifying fever or defervescence, and is unaffected
by patient activity. Accordingly, it will be sometimes be different—but correct.
The following chart presents the range of normal temperatures at the common temperature
measurement sites under normal resting conditions.
Guidelines for Patient Temperature Assessment
Normal Body Temperature (BT)
Normal BT is not a single temperature but a range of temperatures influenced by age,
time of day, and the measurement site.
General Rule of Thumb
On a stable, resting patient, rectal temperature is ~2°F (1°C) higher than
~1°F (0.5°C ) higher than oral temperature.
On a stable, resting patient, arterial temperature ~ rectal temperature.
axillary and
1
Arterial temperature measurement (PA Catheter, TA Thermometry) leads all other
methods in identifying fever or defervescence, unaffected by activities of daily living. It
will sometimes be different from your present methods — but accurate.
Expect the Differences
14
Guidelines for Patient Temperature Assessment
11
..
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11
er Defer Def
.
F
e
v
er Def
..
FF
ee
vv
er Defer Def
deviation at the site of recording.
of obvious environmental causes is usually considered fever. An oral temperature of 100.4°F
(38.0°C ) over at least 1 hour indicates a fever state.
2.2.
Oral TOral T
2.
Oral T
2.2.
Oral TOral T
tients can have a “normal” temperature, even when tachypnea was unobserved.
3.3.
RR
ectal Tectal T
3.
R
ectal T
3.3.
RR
ectal Tectal T
mation of core temperature when the patient’s thermal balance is stable.
during or after surgery, rectal temperature measurement is not suitable, and the possible delay
in diagnosis of a thermal abnormality could lead to an irreversible crisis.
4.4.
AxillarAxillar
4.
Axillar
4.4.
AxillarAxillar
its use in the general patient population should be discouraged due to its unreliable correlation
with core temperature and its poor reproducibility.
5.5.
TT
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5.
T
em
5.5.
TT
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higher than an optimum oral temperature, and close to a rectal temperature.
febrile episodes, the difference can be much higher, mainly because of the artifacts of oral and
rectal sites.
inition: inition:
inition: Clinically, fever is defined as a BT =1.8°F (1°C) above the mean standard
inition: inition:
emem
perature Risks: perature Risks:
em
perature Risks: Oral temperature can be clinically misleading, and many febrile pa-
emem
perature Risks: perature Risks:
emem
perature Risks: perature Risks:
em
perature Risks: Rectal temperature should only be considered as a good approxi-
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perature Risks: perature Risks:
y Ty T
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perature Risks: perature Risks:
y T
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perature Risks: Axillary temperature is contraindicated in critically ill adults, and
y Ty T
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perature Risks: perature Risks:
poral Arporal Ar
poral Ar
poral Arporal Ar
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perature (Tperature (T
perature (T
perature (Tperature (T
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2
A single oral temperature of 101°F (38.3°C ) in the absence
3
4
When monitored
5
6
AA
T) VT) V
alues: alues:
A
T) V
alues: On a stable resting patient, TAT is ~0.8°F ( 0.4°C)
AA
T) VT) V
alues: alues:
7
However, during
Guidelines for Patient Temperature Assessment
Note: If your temporal artery thermometer is marked Arterial
average cooling effect at the mouth, and automatically reduces the higher arterial temperature by that amount.
This allows existing protocols based on oral temperature to be maintained, and results in a reading consistent
with the mean normal oral temperature of 98.6ºF (37ºC) .
6.6.
ComCom
6.
6.6.
parison Beparison Be
Com
parison Be
ComCom
parison Beparison Be
twtw
een Siteen Sit
tw
een Sit
twtw
een Siteen Sit
es: es:
es: Review of published literature reveals mean differences between
es: es:
, it is programmed to compute the normal
Oral
non-TA sites of 0.4° to 3.1°F (0.2° to 1.7°C) with actual differences of up to 6.5°F (3.6°C )
routinely reported, especially in febrile patients.
8
References:
1
Kuzucu EY. Measurement of temperature. Int Anesthesiol Clin, 3(3):435-49, May, 1965
2
El-Radhi AS, Carroll JE. Fever in Paediatric Practice, Ch 2, pp 15-49, Oxford Blackwell Scientific Publications,
1994
3
Hughes WT et al. 1997 Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained
fever. Infectious Diseases Society of America (IDSA)
4
Tandberg D et al. Effect of tachypnea on the estimation of body temperature by an oral thermometer. NE J Med,
308, 945-46,1983
5
O’Grady NP, Barie PS, Bartlett JG, et al. Practice guidelines for evaluating new fever in critically ill adult patients.
Task Force of the Society of Critical Care Medicine and the Infectious Diseases Society of America. Clin Infect Dis
1998 May: 26(5):1042-59
6
Houdas Y, et al. Human body temperature. Ch 5, p89 Plenum Press, 1982, USA, UK
7
Exergen Corporation. Manufacturer’s data on file.
8
Review of subject material peer-reviewed journals.
15
Determining a Fever Threshold for Temporal Artery Thermometry
Threshold DefThreshold Def
Threshold Def
Threshold DefThreshold Def
• A threshold for defining fever is the temperature above which false positives due to
normal variations in temperature, including range of normal mean + circadian effects +
other effects (metabolic, ovulation, etc.) are unlikely.
Threshold fThreshold f
Threshold f
Threshold fThreshold f
• Not all fevers require a fever workup. A fever workup is an early management tool in
assessment of the likelihood of septicemia or bacteremia, and initiated whenever an
infectious source is suspected. The level of temperature triggering such an investigatory
workup is sufficiently high to avoid false positives resulting in unnecessary discomfort
and expense for the patient, but low enough for early identification and intervention.
PrimarPrimar
Primar
Determining a Fever Threshold
PrimarPrimar
y Py P
y P
y Py P
• Temperatures measured with temporal artery thermometry may be higher than normally
seen with other clinical methods, and therefore require an adjustment in both protocol
and perception.
• No one value can apply to every temperature measurement site. Note this old rule of
thumb: Rectal temperature is ~1°F higher than oral temperature and ~2°F higher than
axillary temperature.
or For F
or F
or For F
ointsoints
oints
ointsoints
ining Fining F
ining F
ining Fining F
ee
vv
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e
v
er W
ee
vv
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ee
vv
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e
v
er
ee
vv
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oror
kk
upup
or
k
up
oror
kk
upup
• Recommended threshold for fever workup using arterial temperature assessment is a
single temperature >101.8°F or a temperature >101.2°F sustained for more than 1
hour.
• Adjustment of ~ 1°F is necessary to raise the temperature level normally mandated for
fever workups to prevent false positives, unnecessary cultures and blood tests, etc.
PhPh
ysician Rysician R
Ph
ysician R
PhPh
ysician Rysician R
ecommended Guidelines fecommended Guidelines f
ecommended Guidelines f
ecommended Guidelines fecommended Guidelines f
Temperature Site
Fever Workup
Recommendation
Single value >101.8
Sustained values (>1h)
or For F
or F
or For F
Core &
Temporal Artery
>101.2
ee
e
ee
vv
er Wer W
oror
kk
v
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vv
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up¹up¹
or
k
up¹
oror
kk
up¹up¹
Oral & Temporal Artery in
Oral Calibration
Single value >101
Sustained values (>1h)
>100.4
Axillary
Single value >99
¹Source on file at Exergen Corporation
16
Body Sites for Temperature Assessment
Body Sites for Temperature Assessment
An OvAn Ov
An Ov
An OvAn Ov
Oral TOral T
Oral T
Oral TOral T
Oral temperature measurement is by far the most common clinical method in use today, and is responsible for masking the greatest number of fevers. Oral temperature can be misleadingly lowered by patient
activity such as tachypnea, coughing, moaning, drinking, eating, mouthbreathing, snoring, talking, etc.
Alarmingly, another cause of low oral temperatures is the fever itself. For each 0.6°C (1°F) temperature
elevation, the pulse rate usually increases approximately 10 beats per minute, there is a 7% increase in
oxygen consumption, and the respiratory rate increases approximately 2 cycles per minute. The resulting
increase in respiration can further lower oral temperature
sufficiently to mask a fever.
Figure 1 is of interest as it illustrates fever masking even
when clinicians had eliminated all obvious mouthbreathers
from the study. This emergency room study presents the
temperature difference (rectal minus oral) in 310 patients
with a wide range of respiratory rates. The straight line of
best fit is shown. The stippled area demonstrates the tra- d i -
tional normal difference between rectal and oral temperature (0.3°- 0.65°C). The investigators concluded, that
many patients with tachypnea would have oral temperatures in the normal range despite the presence of clinical
fever, seriously misleading the clinician.
RR
R
RR
Generally, rectal temperature is considered an indicator
of deep tissue and critical tissue temperatures, but longstanding data demonstrate that rectal temperature can
be a lagging and unsatisfactory index. Fifty years ago,
Eichna et al reported differences between intracardiac,
intravascular and rectal temperatures on afebrile patients to be so insignificant that for all practical purposes, the temperatures may be considered to be the same. Certainly rectal temperature is far less invasive than a pulmonary artery catheter, however, in the same study, data on febrile patients support sizeable differences.
erer
er
erer
emem
em
emem
ectal Tectal T
ectal T
ectal Tectal T
vievie
w of Tw of T
vie
w of T
vievie
w of Tw of T
peratureperature
perature
peratureperature
emem
peratureperature
em
perature
emem
peratureperature
emem
perature Measuring Sitperature Measuring Sit
em
perature Measuring Sit
emem
perature Measuring Sitperature Measuring Sit
eses
es
eses
4
3
N = 310
r = .490
P<0.001
2
1
0
TEMPERATURE DIFFERENCE (°C)
10 5020 30 40
RESPIRATORY RATE (MIN-1)
Figure 1 Temperature Difference (Rectal
minus Oral) in 310 Patients with a Wide
Range of Respiratory Rates. The straight line
of best fit is shown. The stippled area
demonstrates the traditional “normal” difference between rectal and oral temperature (0.3
to 0.65°C).
Other comparisons between rectal, esophageal and aortic temperatures undertaken on hypothermic patients by different researchers also confirm similar differences. Subsequent but equally comprehensive
comparisons on healthy volunteers further confirmed not only temperature differences, but also quantified significant lags in rectal temperature vs. hypothalamic temperature by times of order one hour. This is
of interest since the blood as it enters and affects the critical tissue in the hypothalamus should have
considerable significance in thermal homeostasis. However, this early data on hypothalamic temperature
was measured by a thermocouple inserted against (and often times perforating) the tympanic membrane.
With significant improvements in the methodology, more recent clinical observations show that the time
constant of rectal temperature in critically ill patients may be considerably longer, and in some cases as
much as a day.
17
Under certain conditions, rectal temperature is even contraindicated; for example, severe arterial insufficiency in one or both legs might be associated with falsely low readings, or in conditions affecting peripheral blood flow such as cardiogenic shock. More common contraindications include neutropenia, severe
hemorrhoids, and recent anorectal surgery. A less common but serious complication of rectal temperature
measurement is perforation of the rectum, which has even occurred in the absence of predisposing rectal
pathology.
Rectal temperature measurement is not well tolerated by either the patient or the caregivers, and is uncomfortable and embarrassing. Rectal temperature is subject to inaccuracies of placement, environment,
and time of insertion. Although it is well established that a rectal temperature requires two to five minutes
or more to reach optimum measurement with a glass mercury thermometer, in practice many are withdrawn in just one minute, a technique responsible for misleadingly low readings.
In fact, it is difficult to attribute any thermal significance at all to the rectal area. It is not known to contain
any thermoreceptive elements and its geographical location distances it from both the CNS and the crossroads of circulation at the heart, which are the vital informational elements.
TT
ymym
panic Membrane and Ear Tpanic Membrane and Ear T
T
ym
panic Membrane and Ear T
TT
ymym
panic Membrane and Ear Tpanic Membrane and Ear T
A temperature site of more recent onset is the ear. It is a compelling site, accessible, free from bodily
fluids, and not easily influenced by patient activity. This temperature is measured using infrared technology, and there are three types of infrared thermometers: tympanic, ear, and arterial heat balance. It has,
however, become common practice to refer to any thermometer making the measurement at the ear as a
Body Sites for Temperature Assessment
tympanic thermometer. Although the terms tympanic and ear may be used interchangeably, they actually
describe quite different measurements.
emem
peratureperature
em
perature
emem
peratureperature
TT
rue True T
ymym
T
rue T
TT
rue True T
The tympanic membrane is deep inside the skull, and is not subject to the artifactual errors that can affect
oral, rectal, axillary and ear temperatures. True tympanic thermometers provide an uncorrected, direct
reading of the temperature of the tympanic membrane, and are preferred for continual measurement
during certain surgical procedures, and for use in extreme conditions such as military use, research, and
sporting events.
There are two types of instrument used to make the measurement. One is a long thin thermocouple probe,
usually fitted with cotton at the end, that must come in contact with the tympanic membrane. There is
much historical data on the efficacy of tympanic thermometry using contact thermocouples, stemming
originally from work done over thirty years ago. However, this method never gained wide acceptance due to
the risk of injury to the delicate membrane. The other type of instrument is the Exergen Ototemp 3000SD,
which scans the tympanic membrane without contact.
Ear TEar T
Ear T
Ear TEar T
Ear thermometry is a method of measuring the temperature of the external portion of the ear canal. For
routine clinical use, ear thermometry has been preferred as a simpler, faster, and more convenient alternative to true tympanic thermometry. The absolute temperature of the outer ear, however, is lower, and more
variable than tympanic membrane temperature. It is subject to a cooling effect resulting from the body
heat being radiated to the environment, and a heat balance method is required in order to produce the
requisite accuracy. When combined with an arterial heat balance method, ear thermometry provides a
highly accurate indication of body temperature, but those ear thermometers without it have high rates of
missed fevers.
panic Membrane Tpanic Membrane T
ym
panic Membrane T
ymym
panic Membrane Tpanic Membrane T
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peratureperature
em
perature
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peratureperature
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peratureperature
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perature
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peratureperature
18
Reproducibility in Temperature Measurement
Multiple temperature readings in the same area, mouth, rectum, axilla, ear or temporal artery, make for
variability with each separate measurement. This can be confusing for clinicians, since they expect the
same number with each measurement. The non-reproducibility of the readings, however, is not a function of the devices, but simply a function of physiology. The human body is a myriad of small gradients,
and variability of readings will occur on every method of temperature measurement. In addition, thermometers are at room temperature, nearly 30°F (17°C) cooler than the tissue being measured. That
said, it is then easily recognized how time of insertion, probe placement, and tissue cool down all affect
reproducibility of temperature readings, no matter what device is employed.
Oral TOral T
emem
Oral T
Oral TOral T
By far, the most common method of temperature measurement is sublingual measurements. Placement of the probe
under the tongue, however, can result in substantial
differences caused by just a slight repositioning of the
probe. The standard heat chart commonly used by manufacturers of electronic thermometers on the right illustrates
a difference of nearly 2°F (1°C) depending on exactly what
area is being touched by the probe.
Differences from repeated oral temperatures can vary even
further, as they can superimpose artifactual errors over the
thermal gradients. Patient activities also affect the reading,
these varying by individual and activity. In fact, one large
manufacturer cautions waiting at least 15 minutes after
ingesting hot or cold food or drink, after exposure to
extremely hot or cold weather, and after smoking.
peratureperature
em
perature:
emem
peratureperature
Reproducibility of Readings
Ear TEar T
emem
Ear T
Ear TEar T
The journals abound with citations addressing the lack of reproducibility of ear thermometers. In fact,
some manufactureres instruct the user to take three separate temperature measurements, and to select
the highest of the three. While much of this has to do with the device, physiology also plays a large part.
In such a small area, the difference of 30°F (17°C) between the room temperature probe and the
temperature of the ear being measured results in a noticeable tissue cool down. Geriatric patients
typically have a lower rate of perfusion than a younger individual, and it can take several minutes for the
ear to equilibrate following the use of an ear thermometer.
RR
ectal Tectal T
R
ectal T
RR
ectal Tectal T
Time and placement are critical for rectal temperature measurement. It has long been recommended
that the measurement be taken for at least five minutes or more for accuracy. The measurement is also
dependent on the depth of insertion, and just a few centimeters can result in a noticeable difference.
TT
emem
T
em
TT
emem
Because of the expanse of area being measured, and the normally strong perfusion of the artery in
particular, temporal artery temperatures are at least as reproducible as any other method. Of interest,
the temporal artery area will equilibrate in the shortest period of time compared to any other site. For
absolute accuracy, however, it is recommended to wait 30-60 seconds before repeating a temperature on
the same side, although, depending on the individual, the time involved can be much shorter. The
limitation in time is almost entirely the behind-the-ear measurement, as the perfusion rate per tissue
mass is not quite as high as the temporal artery. Since the method employs the area behind-the-ear with
every measurement, this area is the time limitation.
peratureperature
em
perature
emem
peratureperature
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em
emem
poral Arporal Ar
poral Ar
poral Arporal Ar
peratureperature
perature
peratureperature
tt
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peratureperature
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peratureperature
19
Your Temperature
Normal Temperature
Normal human temperature is
around 98.6 degrees. But did
you know that only 8% of the
people in the world have a
normal temperature of exactly
98.6?
Forgotten Physiology
A temperature that is normal
for you may even be a whole
degree or so above or below
“normal.” It is good to know
what is normal for you. Try
taking your temperature at
different times, like in the
morning, after a cold shower, or
after a five-mile hike.
Fever
Fever is when your body’s
temperature control is set
above normal. Fever is a sign
that your body is fighting off
an infection. It is thought that
fever does two things. When
the temperature rises, the
body’s chemical actions speed
up so that damaged tissues can
be repaired more quickly. Also,
virus or bacteria invaders don’t
survive well at high temperatures. Perhaps fever is the
body’s attempt to cook them
into submission.
Chills
You have a high temperature
and cold skin. You are hot
inside, but still you shiver.
Chills are your body’s way of
creating a fever. The muscle
action from shivering produces
heat, which raises your temperature in an effort to fight
off infection. When the crisis
is over, your temperature is set
back to normal, the skin warms,
and you sweat.
112º-114º
Cells begin tCells begin t
Cells begin t
Cells begin tCells begin t
103º-104º
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98º-100º
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malmal
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n upn up
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cisecise
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cisecise
106º
DD
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us fus f
o
us f
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DD
101º
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96º-97º
CoCo
ld weather old weather o
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86º
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e kidse kids
e kids
e kidse kids
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urvivurviv
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Hot Blood or Cold Blood?
A frog in a 70 degree pond is a
70 degree frog. A frog in a 40
degree pond is a 40 degree
frog, and is moving very slowly,
if at all.
A kid in a 70 degree pond is a
98 degree kid. A kid in a 40
degree pond is still a 98 degree
kid, although you can bet he’s
swimming as fast as he can to
get out.
One difference between kids
and frogs is the difference
between warm-blooded and
cold-blooded beings. People
have automatic climate control
inside their bodies. Their
1
Exerpts from Blood and Guts: A Working Guide to Your Own Insides, Allison L, Katz D. , Little, Brown and Company, Boston, New York, Toronto, London
bodies keep them at an even
temperature by carefully
controlling the rate of burning
in their cells.
Frogs are cold blooded,
meaning that their
temperature changes
depending on
where
they
are.
Cold blooded creatures have no
internal temperature control.
Their rate of metabolism is
determined by their
ment.
temperature drops way down, all
their body processes slow way
down.
Humans and all mammals are
souped-up hot-blooded beings.
Their metabolisms are speedy,
but are kept at an even keel.
So no matter what the temperature is outside, the climate
on the inside is ever warm and
ready for action.
When the outside
environ-
1
20
Perspiration
Forgotten Physiology
The Temporal
temperature. In fact, it is measuring the inside by measuring the outside. Your skin is a sensor,
controlling body temperature in two ways: radiation and evaporation. Since most of us don’t think about
our skin as a sensor, this might be a good time to discuss a little physiology.
We live our entire lives with a body temperature that changes only a few degrees. This is thanks to a
very sophisticated climate control, of which the skin is a very important part. Sweating, goose bumps,
and heat loss from the skin all help maintain our normal temperature, keeping us comfortable.
When your internal temperature rises, your brain signals your blood to increase circulation to the skin.
In this way, the body’s internal heat is carried to the surface by the blood, where it is lost by radia-
tion.
If this is not sufficient, your sweat glands sprint into action, and perspiration is released through the
pores. This liquid evaporates on your skin and you cool right down. When your temperature drops, your
brain signals that heat must now be saved. Less blood circulates to the skin, and sweating stops.
Since there is a lot of cooling going on when you are sweating, both inside and out, it is a good idea to
wait till your forehead is dry before taking your temperature with the Temporal
forehead is sweaty, the reading will be low. Drying your forehead could shorten the wait, but there is
another place to measure an accurate temperature when perspiring. It is in the little soft depression
just behind the ear lobe, the place where young ladies are usually taught to apply perfume.
Scanner
relies on the skin over the temporal artery to help provide an accurate body
Scanner
. If your
During perspiration, taking a temperature with the Temporal
has been proven to be as accurate as a temperature taken at the temporal artery area when it is not
wet.
behind the ear lobe remaining dry for the measurement are excellent. And since we already have
increased circulation to the skin during perspiration, this area will have the high blood flow necessary
for the measurement.
Another instance when a high rate of blood flow on the neck can be assured is following head trauma,
either surgical or accidental. At such times the neck area behind the ear lobe can be used as a primary
site if the forehead is not available.
If perspiration or head trauma is not present, the area on the neck behind the ear lobe may not have
sufficient blood flow to be reliable, and should not be used as the primary measurement site.
Since we sweat first on the forehead, then on the hands and feet, the chances of the area
Scanner
in the area behind the ear lobe
21
For Kids Only
Did you know you always have a temperature?
Bet you thought you only had a temperature
when you were sick. Absolutely everything
has a temperature, even icicles.
When you don’t feel well, your mom or a nurse
might say “let’s see if you have a temperature,” but what they really mean is “lets see if your temperature is different from normal.”
So, when you have your temperature taken, don’t be fooled.
Your mom and your doctor already know you have a temperature, and are just getting an idea of how things are going
inside your body.
Brrrrrr!
Places to measure
your temperature
Your bum
little kids get their
temperature taken is in
their bum. Poor little
kids,
The temperature taken in
your bum is the hottest of
all the places to take
temperature. It’s around 99.6°F most of the time
if flying causes the armpit temperature to be the lowest in
your body. It’s around 97.6°F most of the time.
Your mouth.
reading this, you’re probably a big
kid and so you would most likely
have your temperature taken in
your mouth. Not too bad, but
everyone knows you can trick your
mom or your doctor into thinking
you’re sick by doing stuff with
that thermometer.
already know of ways to do that!
Most of the time, a temperature in your mouth is about
98.6°F.
. Babies and
how embarrassing!
Now, if you’re
Bet you
Well, sort of...
.
Your armpit.
a little bit older, they might
have their temp taken under
the arm instead of the bum.
This is better, but you have to
keep the thermometer in
with your arm tight
armpit
against your chest for a long
time. It’s hard to keep it from
falling out and breaking,
especially if you fly! I wonder
When kids get
your
Your ears.
pardon us,
rears.
ear pulled sure isn’t
fun, and when you have
an ear infection, it
even hurts. Temperature taken in your ear
should be higher than
in your mouth, but not
as high as in your rear.
know, though, temperature in your heart is around
99.4°F.
Now we’re down to ears. And please
ears beat
But having your
Your heart.
best place to measure temperature it
would be in the center of your
heart. But that’s pretty dangerous, and surely not be something
you would think was fun.
Arrrrghhh!
If we were to pick the
In case you’d like to
Your temporal arter-
There is a special
ies.
place on your head where
we can measure the same
temperature as the blood
in the middle of your
heart. This is because
blood is pumped directly
from your heart to your
head through little tubes
called arteries that carry
blood up the sides of your neck, up the side of your
face just under your skin, and stop at at a place on your
forehead called your temple. Guess what they’re
called?
touches with her hand when you don’t feel good?
Wow! Isn’t this the same place your mom
Did you know that the forehead has been used to
detect fevers as far back in time as anyone can
remember, over 2000 years? There’s a new technology that scans the same place your mom touches, and
it’s almost as gentle. It’s an infrared thermometer
called the
temperature with a quick and gentle scan across your
forehead. Most of the time, temperature here is
around 99.4°F, same as your heart. Nothing goes in
your mouth, your ear, or your rear, and in just a
second or two, done!
TemporalScanner
. It measures your
Now, where is the best place to take
your temperature?
22
Care and Maintenance
BattBatt
erer
•
•
yy
Batt
er
y: A standard alkaline 9V battery pro-
BattBatt
erer
yy
vides approximately 5,000 readings.
To replace, loosen the single screw at the
bottom of the instrument and remove the cover.
Disconnect the old battery and replace with a
new one in the same location. Replace the
cover, push down to snap shut, and tighten the
screw. Use only high quality alkaline batteries
or equivalent.
Handling: Handling:
Handling: The TemporalScanner is designed
Handling: Handling:
and built to industrial durability standards in
order to provide long and trouble-free service. However, it is also a high precision optical instrument,
and should be accorded the same degree of care in handling as you would provide other precision
optical instruments, such as cameras or otoscopes.
Care and Maintenance
CleaningCleaning
•
Cleaning: The TemporalScanner can be wiped down with any hospital approved disinfectant, includ-
CleaningCleaning
ing bleach, and can even be gas or plasma sterilized. With normal use, the only maintenance
required is to keep the lens on the end of the probe clean. It is made of a special mirror-like, infrared-transmitting material. However, dirt, greasy films or moisture on the lens will interfere with the
passage of infrared heat and affect the accuracy of the instrument. If necessary, clean the lens with
a cotton swab dipped in alcohol. Periodic cleaning is a good practice.
StSt
erilization: erilization:
•
St
erilization: The industrial grade housing and design of the electronic components allow for safe
StSt
erilization: erilization:
gas or plasma sterilization, and for disinfecting with any accepted solution, even bleach. The probe
can even be immersed in cleansing solution because it is hermetically sealed.
CalibrationCalibration
•
Calibration: Factory calibration data is installed via a computer to the TemporalScanner’s micropro-
CalibrationCalibration
cessor. The instrument automatically self-calibrates each time it is turned on using this data, and will
never require recalibration. If readings are not correct, the instrument should be returned for repair.
23
Instructions for Fahrenheit or Celsius Conversion
The TemporalScanner can be used in either °F or °C. To convert from one scale to the other, the only tool necessary
is a paper clip or the tip of a small screwdriver.
FF
or °F/°C Conor °F/°C Con
F
or °F/°C Con
FF
or °F/°C Conor °F/°C Con
• Loosen single screw on bottom of case and remove battery cover.
• Lift battery out of the way.
TT
AA
TT
-4000-4000
T
A
T
-4000
TT
AA
TT
-4000-4000
Care and Maintenance
• Locate the little switch to the right of the battery as indicated in the
drawing, and with the tip of the paper clip or screwdriver, slide up or
down to the opposite position.
• Remove the paper clip or screwdriver.
• To return to the original setting, repeat the process.
LXTLXT
A/TA/T
LXT
A/T
LXTLXT
A/TA/T
• Make sure the display is blank.
• Insert the tip of the paper clip or screwdriver into the slot shown on the drawing, directly below and to the left
of the battery, and push in to activate.
AA
TT
-5000:-5000:
A
T
-5000:
AA
TT
-5000:-5000:
vv
erer
sionsion
v
er
sion:
vv
erer
sionsion
TAT-4000
LXTA/TAT-5000
• While pressing the little switch, slide your finger around the other side of the instrument and turn the instru-
ment on by pressing the red button.
• To return to the original setting, repeat the process.
DD
D
DD
The following chart summarizes the fault conditions, and the associated indications.
D D
ISPLAISPLA
YY
IAIA
ISPLA
ISPLAISPLA
GNOSGNOS
Y
D
IA
GNOS
YY
IAIA
GNOSGNOS
D D
Condition
Condition Display
ConditionCondition
High Target HI 1 beep/second >110 °F (43 °C) >110 °F (43 °C)
Low Target LO 1 beep/second <60 °F (16 °C) <61 °F (16 °C)
High Ambient HI A 1 beep/second >110 °F (43 °C) >104 °F (40 °C)
Low Ambient LO A 1 beep/second <60 °F (16 °C) <60 °F (16 °C)
Low Battery N/A 2 beeps/second bAtt
TICSTICS
TICS
TICSTICS
C C
C
C C
HARHAR
TT
HAR
T
HARHAR
TT
Display Sound
DisplayDisplay
Sound LXTA/TAT-5000
SoundSound
LXTA/TAT-5000 TAT-400 0
LXTA/TAT-5000LXTA/TAT-5000
TAT-4000
TAT-4000TAT-4000
Dead Battery – – – – 2 beeps/second – – – –
Processing Error E-## or Err
Restart. Return to Ex ergen for repair if error m e ssage persists.
24
• Specifications LXTA/TAT-5000
Accuracy ± 0.2 F or 0.1 C ± 0.2 F or 0.1 C
Temperature Range 60 to 110 F (16 to 43 C) 61 to 110 F (16 to 43 C)
LXTA/TAT-5000 TAT-4000
LXTA/TAT-5000LXTA/TAT-5000
TAT-4000
TAT-4000TAT-4000
Care and Maintenance
Arterial Heat Balance Range
for Body Temperature*
Operating Environment 60 to 110 F (16 to 43 C) 60 to 104 F (16 to 40 C)
Resolution 0.1 F or C 0.1 F or C
Response Time ~ 0.1 seconds ~ 0.04 seconds
Battery Life ~5,000 readings ~5,000 readings
Time Displayed on Screen 15 seconds 30 seconds
Size
Weight 8.3 oz (235 gm) 7.0 oz (199 gm)
Display Type and Size Large bright LED's Large bright LED's
Construction Method
Warranty
94 to 110 F (34.5 to 43 C) 94 to 110 F (34.5 to 43 C)
2" x 8" x 1.25"
(5 cm x 20 cm x 3 cm)
•
• Industrial duty impact resistant
• •
casing
•••• Hermetically sealed sensing
system
•••• Stainless steel probe
Lifetime Lifetime
•
• Industrial duty impact resistant
• •
casing
•••• Hermetically sealed sensing
system
•••• Aluminum probe
2" x 8" x 1.25"
(5 cm x 20 cm x 3 cm)
*Automatically applied when termperature is within normal body temperature range, otherwise reads
surface temperature.
Calibration Verification Procedure
All Exergen infrared thermometers are designed to permanently maintain their accuracy, and normally
recalibration is not required unless the thermometer has been physically damaged or experiences
component failure. In the unlikely event that recalibration may be required, the thermometer must be
returned to Exergen for the procedure.
However, calibration can be verified in the lab or clinical units quite easily using a device known as a
portable blackbody. A portable blackbody is a reference heat generator (see below), which is a selfcontained device providing a stable reference target temperature in the clinical temperature range.
The device can be used to verify the calibration of any Exergen thermometer in question, or for quality
checks done on a routine basis. The verifier operates with either a 9-volt power supply plugged directly
into any 120 vac wall receptacle, allowing extended use in the laboratory, or a 9-volt battery for
portable use on the nursing floors.
There are two ways to use the portable blackbody to verify the calibration accuracy of the thermometer
in question, either (1) with a certified master reference infrared thermometer, or (2) by using two
identical thermometers as a reference against the one in question.
25
Using the Portable Blackbody
1. Turn on the verifier device, using either a 9-volt battery or the power supply. Make sure the
red LED is illuminated.
2. Allow device ~5 minutes for warm-up and stabilization time.
3. Allow certified master or the two reference thermometers and the instrument to be tested
to acclimate in the same ambient temperature for at least 10 minutes.
Care and Maintenance
4. For all instruments, make sure the lens at the tip of the probe is clean. To clean, use an
alcohol prep or a swab dipped in alcohol, followed by a damp wipe with water to remove
any residue.
5. Alternately insert the reference instrument(s) and the instrument being verified into the
aperture opening, comparing the readings.
PP
oror
table Blackbodytable Blackbody
P
or
table Blackbody
PP
oror
table Blackbodytable Blackbody
Calibration VCalibration V
Calibration V
2
3
1
4
5
Calibration VCalibration V
1. Power On LED
2. Blackbody Aperture
3. ON/OFF Switch
4. Battery Compartment
5. Power Supply Jack
eriferif
erif
eriferif
ierier
ier
ierier
Using a CerUsing a Cer
Using a Cer
Using a CerUsing a Cer
ence Thermomeence Thermome
ence Thermome
ence Thermomeence Thermome
Blackbody tBlackbody t
Blackbody t
Blackbody tBlackbody t
tiftif
tif
tiftif
o Vo V
o V
o Vo V
ied Mastied Mast
ied Mast
ied Mastied Mast
tt
er in a Per in a P
t
er in a P
tt
er in a Per in a P
erify Calibrationerify Calibration
erify Calibration
erify Calibrationerify Calibration
26
er Rer R
er R
er Rer R
oror
or
oror
efef
erer
ef
er
efef
erer
tabletable
table
tabletable
--
-
--
• Accuracy Limits: Comparison between the reference instrument(s) and the instrument being verified
should be within ±0.4ºF (0.2ºC) for acceptable limits. If not, repeat the process. In the event they
still differ by more than the acceptable limits, call Exergen for repair or replacement of the failed
instrument.
VV
eriferif
V
VV
erif
eriferif
ier Specifier Specif
ier Specif
ier Specifier Specif
ications:ications:
ications:
ications:ications:
Power Source
Power Source 9-volt battery, or 9-volt power supply
Power SourcePower Source
Battery Life
Battery Life Approximately 1 hour continuous use
Battery LifeBattery Life
Care and Maintenance
Low Voltage Indicator
Low Voltage Indicator
Low Voltage IndicatorLow Voltage Indicator
Temperature Range
Temperature Range 97-104 °F (36-40 °C)
Temperature RangeTemperature Range
Cleaning
Cleaning
CleaningCleaning
RR
epairepair
R
epair
RR
epairepair
If repair is required:
• Contact Exergen at (617) 923-9900 for a Return Materials Authorization (RMA) Number.
• Mark the RMA number on the outside of your package and packing
slips.
Red LED shuts off when battery voltage drops below ~5
volts
Wipe down with alcohol or any hospital approved
disinfectant. Do not immerse.
• Include a description of the fault if possible.
• Send the instrument freight/postage prepaid to:
Exergen Corporation
51 Water Street
Watertown, MA 02472
• The instrument will be returned freight/postage prepaid.
27
EXERGEN CORPORATION • 51 WATER STREET • WATERTOWN, MA • 02472 • PH 617.923.9900
EXERGEN
Straight From the Heart°
www.exergen.com
28
p/n 818528 r1
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