Calculating the surface area of a burn: the rule of 9 in infants, children and adults
The rule of nine: when a burn victim comes to the doctor’s attention, there are several factors that must be taken into account to assess the severity of the situation
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Along with the depth of the burn (which can be first, second, third or fourth degree), the severity of burns is also determined by the extent of the injured area; the greater this is, the more insidious is the danger to the burn victim’s life.
There are numerous tables to determine the extent of the burned skin as a percentage of the total body surface area (TBSA).
The simplest and most schematic method is Wallace’s ‘rule of 9’.
It is simple and quick to use, especially for an initial classification at the scene of an accident.
After hospitalisation, more complex tables are used that take into account the exact percentages represented by each body segment according to age.
The most commonly used is the Lund and Browder table you see below:
Used at the time of admission to Large Burn Centres, these tables allow the precise mapping of lesions on pre-printed forms, colour-coded for different depths.
A useful addition to the calculation of the size of partially burned skin areas is the palm of the hand including the patient’s fingers, which represents 1% of the TBSA.
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