OBJECTIVE The purpose of this study was to compare initial rectal and aural (i.e., ear-based) temperature measurements in children with moderate and severe injuries during their trauma care in the emergency department. METHODS A cross-sectional, prospective design was used to compare aural temperature and rectal temperatures in injured children. METHODS A convenience sample of 40 children who met the study inclusion criteria were enrolled at the level I pediatric regional resource trauma center in western Pennsylvania. METHODS Aural temperature was measured by infrared technology (IVAC Corporation, San Diego, Calif.), and rectal temperatures were measured with a thermistor (IVAC Corporation). RESULTS The subjects (N = 40) ranged in age from 1 to 14 years (mean 6.9 years; SD = 4.4 years). The mean difference between rectal and aural temperature measurements (mean = -0.3 degree C; SD = 0.76 degree C) was statistically significant when compared with a paired t test (p < 0.05). The Pearson product-moment correlation coefficient between aural and rectal temperature measurements was moderate to high (r = 0.85). CONCLUSIONS The moderate to high correlation between the two methods shows promise for use of aural infrared temperature measurements as a screening measure for children with moderate and severe injuries.