To the Editors:I read the concerns raised regarding the article "Comparison of Rectal, Axillary, Tympanic, and Temporal Artery Thermometry in the Pediatric Emergency Room" published in the January 2013 issue of Pediatric Emergency Care In response, I would like to present the real scenario in the emergency setup of a developing country like ours. The study was conducted at a tertiary care teaching hospital in Delhi, India. The hospital caters to population of East Delhi and North East Delhi, the most populated districts of the capital, along with adjoining state of Uttar Pradesh, extending to few hundred kilometers. The attendance at the pediatric emergency department is more than 300 patients per day, amounting to more than 12 patients per hour. It further increases in summers, which is the peak season for various infections. The statistics are similar in other public sector hospitals from most developing countries. Data are well maintained in our hospital records. Sixty percent of patients present with fever as the presenting or an associated complaint. In such a busy setting, it is difficult to perform rectal thermometry in each patient. There are time and space constraints while performing the procedure. Rectal thermometry requires a separate examination room for privacy; and in a setting with a single examination room, it becomes challenging to convince patients to have rectal thermometry. Unfortunately, we are not able to provide privacy to all the children for a procedure like recording temperature and have to rely on axillary thermometry.
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