Exergen TemporalScanner 2000 Series User manual

EXERGEN
EXERGENEXERGEN
EXERGEN
TemporalScannerTM 2000 Series
A kinder, gentler way to take temperature
1Greenes DS, Fleisher GR. (Boston Childrens Hospital). Accu-
racy and tolerability of a non-invasive temporal artery thermome-
ter for use in infants. Pediatric Academic Societies/American
Academy of Pediatrics Conference, 5/2000.
More accurate than ear thermometry
1

Temporal Artery Thermometry
T
he temporal artery (TA) area has a long history of
temperature assessment dating back thousands of
years with recorded references to palpation of the head
for fever assessment. Branching from the external ca-
rotid, the superficial TA courses within about a millime-
ter of the skin’s surface over the lateral forehead, pro-
viding good heat conduction to the skin surface, is
readily accessible, and provides no risk of injury from
being touched. Since it is not an anastomosing vessel,
perfusion remains high and stable, ensuring the reliabil-
ity of conditions for the patented Arterial Heat Balance
method to compute accurate temperatures.
This new, superior class of thermometry has been
shown to improve outcomes and reduce costs by non-
invasively measuring temperature with a degree of
clinical accuracy unachievable with other methods of
thermometry.
3

What is arterial temperature?
Arterial temperature is the same temperature as the blood
flowing from the heart via the aorta. It is the best
determinate of body temperature, and unaffected by the
artifactual errors and time delays of oral and rectal
methods.
What is the TemporalScanner?
The TemporalScanner is an infrared thermometer designed
for non-invasive temperature assessment at the temporal
artery (TA). It is a kinder, gentler way to take temperature,
and a better method for patient and clinician alike. It is
breakthrough technology.
How does it work?
Temperature is measured by gently stroking the
TemporalScanner across the forehead, and includes a
momentary touch of the probe to the neck area behind the
ear lobe, to account for any cooling of the forehead as a
result of diaphoresis. The patented arterial heat balance
technology (AHBTM) automatically measures the
temperature of the skin surface over the artery and ambient
temperature, synthesizing the two to produce arterial
About Temporal Artery Temperature
4

temperature by sampling and calculating these paired
readings some 5000 times with each use.
How accurate is it?
It has been clinically proven in all departments for all
patients in premier university hospitals and proven to be
more accurate than ear thermometry.
What are the benefits of TA thermometry?
Besides the inherent accuracy, as a site for temperature
measurement, TA presents many benefits: no risk of injury
for patient or clinician, eliminates the need for disrobing or
unbundling, and is suitable for all ages.
Unique to infrared thermometry, the instrument can be
used with or without disposable covers, thereby providing
a substantial cost savings unavailable with other methods
of thermometry.
About Temporal Artery Temperature
5

Probe Cone
Probe Sensor Lens
Probe
LCD Display Screen
LED Indicator Light
ON Button
Automatic
turn-off in
30 seconds
Product Map
LED Indicator Light
Thumb-Push Ridges
Battery Compartment
9-volt battery
6

TemporalScanner Model 2000 can be used either with disposable
caps (Part No. 134203), or if preferred, without disposable caps by
simply wiping the probe with alcohol or disinfectant between pa-
tients. Model 2100 (with stainless steel probe) always requires
the use of disposable caps.
If using disposable caps, they are easily applied on the probe as
illustrated in Figure 1, and easily ejected by a gentle push of your
thumb as illustrated in Figure 2.
Optional Accessories

A convenient wall or pole mounted dis-
penser holding 50 disposable caps is
available, illustrated in Figure 3 (Part
No. 134202).
Accessories, including disposable caps
are available from the distributor where
you purchased your TAT-2000 Series,
or by calling Exergen Customer Service
at 617-923-9900 or 800-422-3006.
!
7

What you should know before using the TAT:
•Measure only the side of the head exposed to the environment.
Anything covering the area to be measured (hair, hat, wig, ban-
dages) would insulate the area, resulting in falsely high read-
ings.
•Slide the thermometer straight across the forehead, not down
the side of the face. Midline on the forehead, the TA is about a
millimeter below the skin, whereas at the side of the face, the
TA is much deeper, and measuring there would result in falsely
low readings.
•When taking a temperature behind the ear lobe, first push away
any hair, exposing the area. Then, tuck the thermometer on
the neck under the ear lobe, in the soft conical depression be-
low the mastoid, (the place where perfume is typically applied).
•Wait about 30 seconds before measuring the same patient
again to avoid excessive cooling of the skin.
•An infant frequently presents with blankets and clothing cover-
ing the neck area. Since the perfusion rate is normally strong
for infants, and unless visibly diaphoretic, one measurement at
the TA area is typically all that is required. Should you feel the
temperature is low, then push aside any clothing or blankets
covering the neck area for ~30 seconds or so, and repeat the
measurement behind the ear.
Measuring TA Temperature
8

2
Depress the ON button,
Keep depressed throughout
measurement…
Brush hair aside if covering the TA area
Place the probe flush on the center
of the forehead
1
Slowly slide the probe midline
across the forehead to the hair line
3
Brush hair aside if covering ear
Lift probe from forehead and touch
on the neck just behind the ear lobe
4
Release button, read and record
•Display will remain for 30 seconds, before
automatic turn-off.
•To turn off immediately, press and release
•To restart immediately, depress button and
continue as above
5
Measuring TA Temperature
9

What else should I know?
•A dirty probe lens and cone can cause a low reading. If
not shiny, clean the lens and cone with an alcohol prep or
a swab moistened in alcohol.
•It is preferable to hold the instru-
ment sideways. Approaching your
patient with the instrument straight
up and down could be somewhat
intimidating, especially to an agi-
tated patient.
•If you are right handed, you might find it easier to meas-
ure the left side of your patient; a left hander would find
measuring the right side of the pa-
tient to be easier.
•Consider holding the thermometer
like a pencil or pen as illustrated.
•If your patient is agitated, or
squirms away before you have completed your measure-
ment, just keep the button depressed and you can con-
tinue the measurement without having to wait.
Measuring TA Temperature
10

Why measure behind the ear lobe (BE) as well as the
temporal artery?
To avoid any possibility of false low temperature caused
by diaphoresis, which many times is not obvious. Think
of it as a touch of insurance.
How does diaphoresis affect readings?
Moisture cools the skin over the temporal artery area.
Why behind the ear lobe?
If your patient is sweaty, vasodilation will always be pre-
sent, and blood flow BE will be as high as the TA area
were it dry.
What if the TA area has been traumatized by burns or
lacerations, or is completely covered with dressings?
With head trauma, surgical or accidental, the temperature
can be obtained from the alternative site BE. Just as with
diaphoresis, the perfusion will be high.
Why not use the area BE as a sole site?
Without diaphoresis or head trauma, this area is just too
variable to be reliable as a sole site.
Measuring TA Temperature
11

Normal Body Temperature (BT)
Normal BT is not a single temperature, but a range of tem-
peratures influenced by age, time of day, and measurement
site.
General Rule of Thumb
Rectal temperature is ≈2°F (1°C) higher than axillary and ≈1°
F (0.5°C ) higher than oral temperature1
Expect the Differences
Arterial temperature measurement (PA Catheter, TA Ther-
mometry) leads all other methods in identifying fever or defer-
vescence, and is unaffected by activities of daily living. Ac-
cordingly, it will sometimes be different from your present
methods — but accurate.
Guidelines for Patient Temperature Assessment
1. Normal TA Temperature: On a stable resting patient,
TAT is ≈0.8°F ( 0.4°C ) higher than an optimum oral tem-
perature, and is about the same as a rectal temperature.
However, during febrile episodes, the difference can be
much higher, mainly because of the artifacts of oral and
rectal sites.
Clinical Information
12

2. Fever Definition: Clinically, fever is defined as a BT
≥1.8°F (1°C) above the mean standard deviation at the
site of recording.2
A single oral temperature of ≥101°F (38.3°C ) in the ab-
sence of obvious environmental causes is usually consid-
ered fever. An oral temperature of ≥100.4°F (38.0°C )
over at least 1 hour indicates a fever state.3
A single arterial temperature >101.8°F (38.8°C) in the ab-
sence of obvious environmental causes is usually consid-
ered fever. An arterial temperature >101.2°F (38.4°C)
over at least 1 hour indicates a fever state.
While the above are recommended guidelines, not all fe-
vers require laboratory tests, and clinical assessment in
concert with standard hospital protocol for fever workups
should always prevail.
3. Oral Temperature Risks: Oral temperature can be clini-
cally misleading, and many febrile patients can have a
“normal” temperature.4Mouth breathing, tachypnea,
heated gases, and hot or cold fluids can distort the read-
ing, as can intubation or inability of the patient to cooper-
ate. Accordingly, comparisons with TA may not be reli-
able.
Clinical Information
13

Normal Body Temperature Ranges
at Various Measurement Sites
Oronasal
96.6 - 99.0ºF
(35.9 - 37.2ºC)
Axillary
95.5 - 98.8°F
(35.3 - 37.1°C)
Rectal
97.7 - 100.3ºF
(36.5 - 37.9°C)
Arterial
97.4 -100.1°F
(36.3 - 37.8°C)
Oral
96.6 - 99.5ºF
(35.9 - 37.5°C)
Esophageal
98.4 -100.0ºF
(36.9 - 37.8°C)
Clinical Information
14

.
4. Rectal Temperature Risks: Rectal temperature should
only be considered as a good approximation of core tem-
perature when the patient’s thermal balance is stable, but
is not suitable during and after surgery,5and may be
misleading after antipyretics, physical exercise, or other
intervention that may change temperature quickly.
5. Axillary Temperature Risks: Based on strong evidence
cited by the NIH, “axillary temperature is contraindicated
in critically ill adults, and its use in the general patient
population should be discouraged due to its unreliable
correlation with core temperature and its poor reproduci-
bility.” 6
References:
1 Kuzucu EY. Measurement of temperature. Int Anesthesiol Clin, 3(3):435-49,
May, 1965
2 El-Radhi AS, Carroll JE. Fever in Paediatric Practice, Ch 2, pp 15-49, Ox-
ford Blackwell Scientific Publications, 1994
3 Hughes WT et al. 1997 Guidelines for the use of antimicrobial agents in neu-
tropenic patients with unexplained fever. Infectious Diseases Society of
America (IDSA)
4 Tandberg D et al. Effect of tachypnea on the estimation of body temperature
by an oral thermometer. NE J Med, 308, 945-46,1983
5 O’Grady NP, Barie PS, Bartlett JG, et al. Practice guidelines for evaluating
new fever in critically ill adult patients. Task Force of the Society of Critical
Care Medicine and the Infectious Diseases Society of America. Clin Infect Dis
1998 May: 26(5):1042-59
6 Houdas Y, et al. Human body temperature. Ch 5, p89, Plenum Press, 1982,
USA, UK
Clinical Information
15

Cleaning the Instrument
•Probe lens and cone should be shiny
clean, if not, wipe with an alcohol prep, or
with a swab moistened in alcohol or water.
•Hold upside-down to prevent excess
moisture from entering the sensor area. It
will not harm the sensor, but if it becomes
too wet, you will be unable to take a
temperature until it dries.
•Thermometer case can be cleaned with
any hospital approved disinfectant, alcohol,
even bleach solutions. Avoid gritty,
abrasive cleaners as they can scratch the
thermometer.
•Do not hold the TemporalScanner under
the faucet or submerge in water. It is not
waterproof.
The TemporalScanner is an optical instrument. Like a camera or
eye glasses, a dirty lens will distort the view. If the thermometer is
unable to see the heat clearly, it will be unable to measure it ac-
curately, resulting in low readings.
16

Blinking battery icon with temperature dis-
played: battery is low but will still operate cor-
rectly. Replace soon.
Blinking battery icon with 2 dashes: not
enough energy in the battery to measure
correct temperature. Replace battery.
Remove the battery compartment door by
squeezing on the ridges with your thumb,
and pushing away as indicated.
Insert a 9-volt battery as illustrated, with the
positive (small terminal) always on the right.
Replace the battery compartment door as in-
dicated, with a push of your thumb on the
ridges.
Changing the Battery
17

ERR
A flickering Scn on display is visible during meas-
urement. At completion, releasing the button will
display and lock temperature on the screen for 30
seconds.
The target temperature measured is higher than
107.6°F (42°C).
The target temperature measured is lower than 60°
F (15.5°C).
Temperature of the thermometer is higher than
104°F (40°C). Let the instrument acclimatize for
about 10 minutes or so in the area in which it will be
used.
The temperature of the thermometer is lower than
60°F (15.5°C). Let instrument acclimatize for about
10 minutes or so in the area in which it will be used.
EMI/RFI (like static on a radio) protection is prevent-
ing a temperature from being taken. Wait a minute
and you should be able to proceed. If not, reset by
removing and replacing the battery. Be sure battery
is tightly connected. Call Customer Service if error
message reappears.
KI.A
L0.A
Display Messages
18
°C/°F Conversion
If thermometer is reading °F and you would like to convert to °C,
locate small wire loop on left side of circuit board, just above the
battery and snip loop open with small scissors or other small cut-
ting tool. Call Exergen for assistance if needed.
L0
KI
SCN

Clinical Accuracy Meets or exceeds all ASTM and MDD
93/42/EEC standards for radiation ther-
mometers.
EMI/RFI Protection Error message displayed
Calibration Protection Error message displayed
Temperature Range 15.5 to 42°C (60 to 107.6°F)
Operating Environment 15.5 to 40°C (60 to 104°F)
Resolution 0.1°C or °F
Response Time Approximately 0.03 second
Time Displayed on Screen 30 seconds before automatic shutdown
Battery Life Approximately 7,500 readings
Size 7.0 in x 1.75 in x 1.25 in
(17.8 cm x 4.45 cm x 3.18 cm)
Weight 4.16 oz (120 grams) incl batt
Display Type High contrast LCD’s
Construction Method Impact resistant casing,
hermetically sealed sensing system
Warranty 3 Years
Patents Protected by one or more of the following US
patents: 6056435, 6047205, 6045257, 5893833,
5874736, 5653238, 5628323, 5445158, 5381796,
5325863, 5199436, 5017019, 5012813, 4993419,
4874253, 4636091, RE035554, D03708. Other
US and foreign patents pending.
Product Specifications
19

EXERGE
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EXERGE
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EXERGE
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EXERGE
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Strai
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EXERGEN CORPORATION . 51 WATER STREET . WATERTOWN, MA, 02472
PHONE: [phone] . FAX: [phone]
www.exergen.com
Three Year Warranty
Exergen Corporation warrants each new Exergen TemporalScanner 2000 Series
(except battery) against defects in materials or workmanship for a period of three
years from the date of purchase, and agrees to repair or replace any defective
product without charge.
IMPORTANT: This warranty does not cover damage resulting from accident, mis-
use or abuse, lack of reasonable care, the affixing of any attachment not provided
with the product or loss of parts or subjecting the product to any but the specified
battery.* Use of unauthorized replacement parts will void this warranty.
Exergen Corporation will not pay for warranty service performed by a non-
authorized repair service and will not reimburse the customer for damage resulting
from warranty service performed by a non-authorized repair service. No responsi-
bility is assumed for any special, incidental or consequential damages.
In order to obtain warranty service, simply call Exergen Corporation Customer
Service, 617-923-9900, for an Return Material Authorization number (RMA). Then
send the product, postage or shipping prepaid, to Exergen in accordance with the
instructions given with the RMA number. It is suggested that for your protection,
you ship the product, insurance prepaid. Damage occurring during shipment is
not covered by this warranty.
NOTE: No other warranty, written or verbal, is authorized by Exergen Corpora-
tion. This warranty gives you specific legal rights and you may also have other
rights which vary from state to state. Some states do not allow the exclusion or
limitation of incidental or consequential damages, so the above exclusion and limi-
tations may not apply to you.
*Read enclosed instructions carefully.
Developed, designed, and manufactured by Exergen Corporation in the USA.
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P/N 818503 Rev 2