BURN SIZE ASSESSMENT
Establish the size of the burn and describe it as the percentage of the total body surface area that is burnt- %TBSAB. This will guide fluid management and potentially futility decisions.
• The ‘rule of nines’ is not accurate in children, use a Lund and Browder chart (next page) • Skin erythema without blistering is not counted in %TBSAB
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• The palmar surface of the whole hand including fingers is about 1% TBSA • Burn depth evaluation can be difficult. It is easiest to divide into: ·· Superficial; where dermal capillary refill can be demonstrated ·· Deep, where there is no dermal capillary flow
10: BURNS
• Do not rely on initial assessment of depth if the patient is hypovolaemic or hypothermic, reassess once resuscitated • Be aware, burns may evolve and %TBSAB increase as a result.
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