It is now 4 pm, so need ml over next 7 hours:. Partial thickness burns do not extend through all skin layers, whereas full thickness burns chatr through all skin layers into the subcutaneous tissues. Wallace rule of nines —This is a good, quick way of estimating medium to large burns in adults. The scale of the tragedy shocked the nation and briefly replaced the events of World War II in newspaper headlines.
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Abstract Background The Lund and Browder LB chart is currently the most accurate and widely used chart to calculate total body surface area affected by a burn injury. However, it is not easy to use charts to calculate burn percentages because of the difficulty in performing mathematical calculations with the percentages attributed to various body regions that are only partially burned. It is also cumbersome to have to perform mental calculations, especially in emergency situations.
Methods We compared results from the LB chart with a modified Lund and Browder MLB chart using 10 assessors on five different burn wounds each drawn on both charts. Using this chart will help burn care providers rapidly, accurately, and reliably estimate burn extent.
Keywords: body surface area, burns, diagnostic techniques, surgical INTRODUCTION Determination of the percentage of total body surface area BSA involved in a burn injury is important, as this value is used for fluid resuscitation, transfer decisions, further management, prognosis, and research.
Computerized methods of burn size estimation are also available using planimetry [ 1 ], three-dimensional photography [ 2 ], and smart phone applications [ 3 ] and these are reported to be very accurate but have not yet found wide acceptance. There can be considerable variation among observers in assessing the same burn wound [ 4 ], and overestimations are common and can lead to fluid overload and further incorrect management decisions.
This is also an inconvenient method to use for larger burns. The rules of nine method, published by Wallace in [ 7 ] as a simplification of measurements performed by Berkow in [ 8 ], is in common usage though overestimations are reported, especially in persons with high body mass index [ 5 ]. Even though the LB chart Figure 1 [ 10 ] is considered the most accurate of these three methods, it is still prone to errors [ 11 ].
Using the LB chart itself is not easy, especially in emergency situations [ 10 ]. Estimates have to be made and mental calculations have to be performed, usually involving fractions, and can results in miscalculation. Results may vary significantly among observers [ 4 ], and this variability is inversely proportional to accuracy. From the first responder to specialists, assessment of burn area may have to be conducted multiple times and by people with varying degrees of training and experience.
The method used for this assessment must be as robust, precise, reliable, and repeatable as possible.
Initial management of a major burn: II—assessment and resuscitation