Sensitivity and Specificity of Caregivers’ Assessment of Fever without a Thermometer in a Paediatric Emergency Department

NICE guidelines recommend that reported parental perception of a fever should be considered valid and taken seriously by healthcare professionals. This study aimed to assess the sensitivity and specificity of parental perception of pyrexia – without measuring with a thermometer - upon attendance to the paediatric ED, as many parents were anecdotally noted to treat pyrexia without objective measurement.

Methods: This prospective observational study was approved by the institutional Ethics Board. Children of triage category 2 or lower who presented with a non-trauma related presentation were invited to participate through their parents. As part of nursing triage prior to measuring the child’s temperature parents were asked if and why they thought that their child had a temperature in real time.

Results: 60% (n=168) of the 278 valid records returned were male, and 75% (n=211) were Irish. More than half (53%) of children had received antipyretics at home before presentation to the ED. Just over 7% (n=20) were admitted as inpatients to the hospital. Only 12.9% of children included in the study were pyrexic (body temperature ≥38° Celsius). Parents perceived pyrexia in 23.7% (n=66) children. Just under 84.5% of parents were correct in their assessment of their child’s fever, giving parental assessment of pyrexia (without a thermometer) a sensitivity of 81% and a specificity of 85%.

Conclusion: Caregivers’ assessment of fever in paediatric patients attending our Emergency Department was sensitive and specific. Further analysis should be performed.