Background: Temperature screening checkpoints have become widely distributed during the COVID-19 pandemic, using various contactless methods of temperature measurement, including wrist and forehead measurement. Aim: In this study we aim to investigate the sensitivity and specificity of these two temperature measurement methods – wrist and forehead – compared with the standards of sublingual or axillary measurement. We also aim to investigate the influence of age, gender, device brand and diurnal effect on the temperature reading. Methods: Participants were randomly assigned to one of two groups, each group using a different temperature measurement device. All participants had their forehead and wrist temperature measured, and this was compared to their axillary or sublingual readings. Results: The area under the curve for wrist measurement was 0.49 (95% CI 0.34 and 0.64), p>0.05, with a sensitivity of 46.2% and specificity of 53.3%, while the area under the curve for forehead measurement was 0.70 (95% CI 0.51, 0.89), p<0.05, with a sensitivity of 23.1% and specificity of 76.9%, PPV 1.59% and NPV 97.7%. Conclusion: Wrist and forehead temperature measurement is not accurate in detecting fever during the ongoing COVID-19 pandemic. Although forehead measurement is also not an ideal method, it nevertheless appears more consistent than wrist measurement.
Background: Pain assessment in ICU patients turns out to be a daily challenge for the attending teams, particularly in those patients who are intubated endotracheally; on mechanical ventilation or analgosedated as such patients are unable to self-assess existence and intensity of pain. Guidelines to identify pain in these patients are crucial for physicians for effective management. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1994, through March 2017. The following search terms were used: pain management in ICU, pain in ICU, pain assessment by behavior, pain assessment in intubated patients. Aim: Our aim in this study was to understand how to assess and manage pain in an intensive care unit patient, particularly those patients who are unable to self-report or assess. Conclusion: Physical clues given by comatose or intubated patients in critical care unit must be used as a method to identify existence of pain, and must be managed effectively to decrease discomfort and prevent short and long term adverse effects.
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