Maternal screening of childhood fever by palpation

Fever is a common chief complaint for the pediatric emergency patient. It has been reported that a mother's tactile examination of a child, as historical information, offers little useful information. The study objective is to determine whether mothers can accurately detect the presence or absence of a fever without using a thermometer. The study is a prospective comparison of historical information with measured temperature, performed over a two-month period. The settings are in two inner-city university hospital emergency departments. Mothers of children less than 10 years old who presented to the emergency department with any chief complaint were selected as subjects. The interventions were interviewing the mother and the performance of routine vital signs on the child. Three hundred and twenty-two mothers participated. Of 124 febrile children, 104 mothers accurately detected a fever in their children (sensitivity 84%), while of 198 afebrile children, 150 mothers accurately detected the absence of fever (specificity 76%). We conclude that mothers are able to provide accurate information about the presence or absence of fever in their children by touch and without the use of a thermometer. Thus emergency physicians should heed the historical statements of mothers presenting with only the subjective complaints of fever and no history of thermometer use.