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Extent of Burns (In Terms of TBSA) Rule of Nines Head/neck = 9% Each arm = 9% Each leg = 18% Chest = 18% Back = 18% Perineum = 1% Palm = 1% Lund-Browder Chart: more accurate; accounts for differences in body proprtions with age Location of Burn Face/neck: airway concerns: indicates possible inhalation injury Circumferential chest burn: inhibits chest movement/breathing Hands, feet, joints, eyes: self-care deficits Ears/nose: infection rsik (poor blood supply) Buttocks, genitalia: infection risk Circumferential extremity: distal circulatory concerns Types of Burn Injury 1. Thermal (flame, flash, scald, contact) 2. Chemical (from necrotizing substances) 3. Electrical 4. Smoke and inhalation injury a. CO poisoning: majority of deaths at fire scene b. Injury above glottis c. Injury below glottis Patient Factors 1. Age 2. Pre-existing disease 3. Concurrent injury Major vs Minor Major if: Deep partial thickness covers > 25% or Full thickness covers > 10%, or Hands, feet, eyes, ears, face, perineum involved Inhalation injury, electrical burn, complicated injury, high-risk patients
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