Temperature measurement Flashcards

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1
Q

what body sites can be used to measure temperature? and compare them.

A

tympanic - best measure of cerebral temp. fast but ear wax can reduce accuracy.

oesophageal (lower third)- good measure of core temp , more accurate

bladder - good measure of core temp but affected by flow and invasive

rectum - few degrees higher than core temp due to insulation and fermentation from bacteria. slight delay too.

skin - peripheral temp measurment

gold standard = pulmonary artery flotation catheter with thermistor . v. accurate but v. invasive.

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2
Q

what is the difference between core and peripheral temp?

A

core temp is a measurement of internal temp
peripheral temp is at the skin peripheries
usually a difference of 1-2 degrees

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3
Q

Give an overview of the methods used to measure temp..

A

These can be divided into electrical or non electrical

electrical:
* resistance thermometer
* thermistor
* thermocouple
* infrared tympanic membrane thermometer

non electrical
* bimetallic strip dial thermometer
* bourdon gauge dial thermometer
* liquid expansion thermometer
* liquid crystal thermometer

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4
Q

describe how a liquid expansion thermometer works?

A

As temperature increases it causes a liquid to expand.
A consists of a bulb containing liquid of either alcohol or mercury in continuation with a transparent glass column which has a calibrated scale along it.
as the temp increases, the liquid rises up the tube and settles at a value along this scale.

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5
Q

what are the pros and cons of a liquid expansion thermometer?

A

pros - simple, portable, not electronic

cons = risks associated with mercury poisoning, slow response , risk of glass breaking and causing injury. alcohol inaccurate at high temp, mercury innacurate at low temp

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6
Q

how does a bourdon gauge thermometer work?

A

based on principle that gas will expand with increasing temp - charles law

bulb with a spiral hollow tube containing gas
as the temp increases, the gas expands and the spiral unwinds
the spiral is connected to levers and a pointer which will move along a calibrated scale to read the temp

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7
Q

what are the pros and cons of a bourdon gauge thermometer?

A

easy to use, portable, non electric, continous measurements

slow response time
can demonstrate drift with time and hence needs recalibrating or becomes less accurate (changes to compliance of levers)

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8
Q

how does a thermistor work?

A

thermistors consist of metal oxides and act as semiconductors
these usually have a negative temp coeffient such that as temp increases, their resistance decreases with an exponential relationship

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9
Q

pros and cons of thermistors?

A

pros - very sensitive, cheap, quick response time ,very small so can be incorporated into catheters as small e.g PAFC

cons - more likely to have calibration error due to non-linear scale, prone to hysteresis and drift.

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10
Q

how does a thermocouple work?

A

Uses principle of seebeck effect
2 metals are used and at their junction a voltage between these is produced and measured. this will vary with temp
one metal is kept at a constant temp and the other is used as the measurement part.
usually copper and constanan

amplitude of voltage change is proportional to temp change - positive linear relationship

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11
Q

pros and cons of a thermocouple?

A

pros - fast, cheap, small

cons - voltage small and needs amplifying, reference needs to be kept constant - both of these can result in errors.

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12
Q

how does a bimetallic strip dial thermometer work?

A

2 dissimilar metals are used in a coil
each has a different thermal expansion coefficient

as temp changes they will expand to varying degrees causing the spiral to uncoil.
connected to levers and a pointer on a calibrated scale.

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13
Q

what are liquid crystal / chemical thermometers?

A

based on thermochromism - optical properties and colour of crystals change with temp

applied to forehead

cheap
however insensitive

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14
Q

pros and cons of bimetallic strip dial thermometer

A

cheap and robust
continous measurement

accuracy reduces with time due to changes in compliance - needs recalibration.
slow response time.

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15
Q

how does a resistance thermometer work?

A

uses a metal and the fact that the resistance of metals increaases with increasing temp in a linear relationship.

usually platinum wire

circuit include battery, ammeter and platinum wire + sometimes wheatstone bridge to improve accuracy.

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16
Q

pros and cons of a resistance thermometer

A

v accurate (used to calibrate others), sensitive and work across wide range of temps

however bulky and fragile, slow response time and hysteresis is source of error

17
Q

draw a graph comparing thermocouple, resistance thermometer and thermistor

A
18
Q

how does an infrared tympanic membrane thermometer work?

A

based on the fact that all objects emit radiation above 0K, the hotter, the more.
detects infrared radiation emitted by objects. the wavelength and intensity of this radiation depends on temp.
then converts it to electrical current for procesing and display of temp

may use pyroelectric sensors = crystals that alter current depending on infrared radiation

19
Q

pros and cons of infrared tympanic membrane thermometer

A

pros - quick, accurate

cons - in tympanic membrane can be inaccurate with ear wax, some risk to perforation of tympanic membrane

20
Q

when are mercury vs alcohol liquid expansion thermometers used?

A

mercury has a melting point of -39 degrees and a boiling point 250 degrees and so is used for higher temps
alcohol has a melting point of -119 degrees and boiling point of 78 degrees so is used for colder temps.

21
Q

why are mercury and alcohol chosen as liquids for liquid expansion thermometers?

A

both have a linear relationship with expansion and temp and thus easy to make a calibrated scale.

22
Q

what is a thermopile?

A

multiple thermocouples in parallel - improves sensitivity

23
Q

how is core body temp measured intraoperatively?

A

nasopharynx

distal oesophagus - more accurate , not affected by air from respiratory tract , more accurate for cardiac temp.

pulmonary artery - gold standard but v invasive

tympanic membrane - accurate if no ear wax plus not continous

24
Q

NICE guidelines on intraop temp management

A

induction only when >36
measure every 30 mins atleast
anymore than 500ml fluid should be warmed
cover patients where possible
>30min surgery use a bear hugger
measure temp post op too