Assessing the extent of a burn

To guide management goals, it is important to assess both extent and depth of the burn.

To assess the extent of a burn it is vital to expose all areas of the body to accurately estimate percentage TBSA affected. This is essential to:

Decide whether the patient requires fluid resuscitation (>10% TBSA in children or >20% TBSA in adults)
Calculate the fluid requirement during the initial resuscitation period if needed

Common ways to estimate %TBSA are:

Lund and Browder charts (fig 7a)
Using the patient’s palm (including finger and thumb surfaces) as an estimate of 1% TBSA
Rule of 9s (fig 7b)
Mersey Burns App (fig 7c) which enables the user to highlight areas of burn tissue on a model to accurately estimate %TBSA affected.

Not all of the burn area would necessarily be included in the %TBSA calculation. The depth of burn needs to be considered.

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