How effective is hand fever detection?
Long before thermometers were used in clinical medicine, mothers detected fever by touching their hands to the baby. How accurate is the determination of temperature by palpation?
Bergeson decided to find out the value of palpation as a screening method for fever. To do this, more than 1000 children aged from several days to 18 years of age at admission to the clinic measured rectal or oral temperature using a standard mercury thermometer.
In addition, the nurse, palpating the skin of each child, determined its temperature, making one of the following conclusions: the child does not have a fever, there is a moderate fever (38–38.9 ° C), there is a high fever. Nurses did not specifically teach palpation or the detection of fever. In the overwhelming majority of cases, the normal temperature was correctly estimated; only in 1.8% of cases fever was mistakenly diagnosed.
In contrast, 42% of children with fever had erroneously recognized a normal temperature. Three feverish children, despite the temperature above 39 ° C, were in the Group of healthy children. Thus, if, after palpating the skin, we decide that the child has a fever, then this will probably be correct.
However, if the child does not feel the heat, then this does not mean the absence of fever. Therefore, palpation cannot be used as a reliable screening method for the diagnosis of fever.
Tomlinson studied how accurately mothers from the middle social class evaluate the readings of a normal mercury thermometer at various body temperatures in a child. The study of a group of 58 mothers, compiled by the method of random selection, showed that, in general, they cope with this task well. Errors of more than 0.1 ° C were observed in approximately 4% of cases, and in all these cases, the mother lowered the temperature.