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 >15% 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 12a)
  • Using the patient’s palm (including finger and thumb surfaces) as an estimate of 1% TBSA
  • Rule of 9s (fig 12b)
  • Mersey Burns App (fig 12c) which enables the user to highlight areas of burn tissue on a model to accurately estimate %TBSA affected
Figure 12a

adapted from:

Figure 12b

Ref: Modified from

**Link to app store Mersey burns app store**

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

Top tip:

  • Epidermal burns are not included when calculating the burn %TBSA
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