Variation of Axillary Temperature and Its Correlation with Oral Temperature v Singh*, A Sharma**, R Khandelwal***, K Kothari**** Abstract Unilateral axillary temperature is recorded in unconscious patients and children due to its easy approach. © Objective : To evaluate variation of axillary temperatcre on the two sides and temperature. + Subjects : One hundred and 46 healthy men and women, aged 12 through $2 years. + Methods : Axillary temperature from both sides and oral temperature were recorded using digital electronic ‘thermometer in supine position with due precautions. + Results : Difference in temperature on the two sides of axilla was found to vary by as much as 0°F to 3.4°F, Therefore, the data was grouped into higher and lower temperature ranges. The difference between mean oral correlation ith oral and mea lower axillary temperature was 1.0°F + 0.80°F (r= 0.84). = Conclusios represents t Based on our observ yer axillary temperature was found to be 0.5°F + 0.6°F (r= 0.564) wl temperature was 1.0°F + 0.89°F (r = 0.64). The difference between mean oral that in comparison to mean and mean asillary ns, it is found that an average of temperature of both sides of axilla xillary temperature moze accurately and to get the correct oral equivalent of axillary temperature fone should ada 1° F to the mean axillary temperature. (TAPI 2000; 48 : 898-900) Introduction Body temperature is recorded in axilla, mouth, rec- wm and lower oesophagus, Among all of these sites, lower oesophageal temperature closely reflects the core temperature.' But, recording of oesophageal tem- perumre is esmbersome. Therefore, oral temperature is recorded most commonly. However, in children and in soine adult patients such as unconscious ones, uni lateral avillary temperature is recorded more frequently on account of its easy accessibility. Only a few studies are available to suggest correct values and method of recording axillary tempera- ture 234 wersies exist?" standard textbooks susgest 2 lary temperature to infer its oral We undertook this study to assess the accuracy of axillary temperature and its correlation with oral tem- perature. “Associate Professor; "Research Assistant; >= Senior Registrar, #**Professor and Head, Department of Medicine: SMS Medieat College, Jaiper. Material and Methods One hundred and forty six healthy subjects, aged 12 years through 52 years, volunteered to participate in this ‘study. A brief questionnaire was administered to rule out Febrile illness present by or inthe recent past in the sub jects. Thermometery —, ‘Gfal and axillary temperatures were recorded in supine position. ANI measurements were taken by specially tained nursing personnel using standardised digital electronic ther- someter. This thermometer has a range from 90°F 19 106° with accuracy upio one digit beyond decimal. Zero error vas eliminated initially and the recording of temperature was done after hearing the final display tone. The same thermometer was used 10 record the temperature in the «wo armpits and the mouth. The thermometer was positioned in tm sublingual space for recording oral temperature. The subjects were advised not to eat, drink or smoke 15 minutes prior to each measurement, For recording of axl tem- perature. the thermometer was Kept in the armpit with the arm addlucted close to the chest wall, The recordings were ‘made usually tthe some time of the day. keeping the 2mbie ent conditions of temperature, humidity, etc, the sa Results In atl. 146 tea inaiviterance in anitary tmp. on two sdesF) Fig. 1: Bilateral axillary temperature difference, study. Their mean age was 35.2 4 8.4 years {range 12 to 52 years). Out of them, 112 (76.7%) were males and 34 (23.3%) were females. ‘The mean oral temperature was found to be 98.7°F + 0.69°F. The mean of right and left axillary temperature was found to be 97.7°F + 0.89°F. The difference between meen foal and mean axillary temperature was 1.0°F + 0.B0°F (1 = 088) ‘The axillary temperatures on the two sides of the body, however, varied. This difference ranged from O°F to 3.4°F. Therefore, the temperature data on the two sides was grouped into higher and lower temperatures. The mean tert- peratures of the higher and the lower sides were calculated. ‘The mean axillary higher temperature was 98,2° F + 0.7° F while mean axillary temperature with lower values showed mean of 97.2°F + 1.08°F (Table 1). ‘Table 1: Obsorved mean temperatures Mean Standard temperature (°F) __deviation °F) Onl 98.7 069 Auillary Higher) 982 o77 Axillary (Lower) 972 1.08, Average axillary 917 039 See ‘The difference between the mean of oral and that of the higher axillary temperature was 0.5°F + 0.6°F (¢ = 0.564), While that with reference to the mean of the lower axillary temperature was 1.5°F + 0.89°F (r= 0.64) (Table 2) Discussion ‘Though oral temperature is recorded most com- JAPI2000, VOL. 48.NO.9 No.of Subjects ata) Temperature dferenceF) Fig. 2: Dilferenee of oral and mean axillary ‘Table 2: Difference of mean temperatures Mean smperatre °F) Oral- Axillary (Higher) 03 Ora -Axitary (Lower) 15 Onl Axillary 10 ‘monly in clinical settings, yet in situations like como tose patients and children, axillary temperature is taken. Concepts regarding correct values of normal human body temperature are based on Wunderlich’s observa tions 120 years ago. Standard textbooks suggest adding 1°F to axillary temperature to get an approxi- mate value of oral temperature.® But, as is evident from our observations, there were differences even in the axillary temperatures on the two sides, and this difference was more than 2°F in some cases (range from O°F to 3.4°F). Takagi Kentaro (1960)? also re- corded such variations in normal human axillary body temperature on the two sides. If we take the higher side axillary temperatures and add 1°F to it, we would have an erroneous higher value of calculated oral equivalent temperature, On the contrary, if we take the lower side axillary tem- peratures, and add °F to it, we again would have an erroneous lower value of calculated oral equivalent temperature. However, if we take the mean of both ax- illary temperatures and then add 1°F, we witl got a close approximation of the oral temperature (Table 2). Monitoring of fevee and administration of antipy- 908 siies requires meticulous eare in recording of tem- Herison’s Principles of tneral Mec. 1808 BA, USA, perature, especially children and unconscious ‘McGraw Hill Companies. 1998: 84-90. Pails Alou (any auahors hive tiled foi 2. Horvath SM, Menduke Hf, Picrsol GM. Oral end recta te range of normal human body temperature, — oral 4 We taen a Hi ‘i ie ‘as well as axillary,!3° -- there has been no study in - we Serguin tical thermometry and the past which has taken into account the variability of uman temperate, New York, NY, Wiliam Wood ad Co axillary temperature on the two sides. It was found that age did not significantly influence temperature ‘4, Wunderlich CA, Reeve JC. The course af the temperature 1 in disease: a guide to clnial thermemetry. Aw J Med! Sci within the age range 12-52 years. (Linear regression, P 1869: 87: 425-47. =0.99) é 5, Muckowiak PA, Wasserman SS, e af. esa! apprieal We conclude by offering the following guidelines of 98.6°F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wundetich to get the correct value of normal human body tem- esa ea perature by axillary measurement: 6. Tanner JM. The relationship berween the feqsency ofthe + Axillary temperature should be recorded prefer- 2 rey Dean, oral temperature and recta temperature in man at rest. ably from both sides and an average of the two {Physiology 1951 : 115: 391-409. sides represents the axillary temperature more ac- 7, Dinarello C, Wolff S. Pathogenesis of fever in man. N Eng? curately. 4 Med 1978; 298 : 607-12, #To get the correct oral equivalent of axillary tem- 8 Michael Swasb. Hutchison's cliniat methods. 19h E34 perature, one must add I°F to the mean axillary London, ELBS. 1989; 36-7. temperature. 9, Takagi Kentaro, Influence of skin pressure on temperate regulation. In: Essential problems in elimaie physiviog Yoshimura H, Ozata K. Itoh $ (eds) Kyoto, Japan, Nankodo 1. Gelfand JA, Dinarello CA. Fever and hyperhermi tn Publishing Co, Lid. 1960: 213-49 References Announcement | Und Annual Cardiological Society of India Conference, North East Chapter, is being held in | | For further details please contact - Dr. Daljit Singh Sethi, Organising Secretary and Conference | | Secretariat. Don Bosco Road, Laitumkhrab, Shillong 793 003. Phone No. : 0364 784 Fax :0364 500670, Mobile : 98630 60476. So. Shiliong ou: the 30th September and Ist October, 2000. 4, (R) 227477 Dr. DS Sethi 200 JAPI2000, VOL, 48, NO. 9