Evaluating burn severity by assessing depth and the %TBSA burns is and important step during the head-to-toe examination. This assessment will:
- help to determine the severity of injury
- determine whether the person needs to attend a specialized burn centre and the degree of urgency to do so
- %TBSA assessment will also allow fluid resuscitation requirements to be calculated
REMEMBER: DO NOT INCLUDE ERYTHEMA (EPIDERMAL BURNS) IN THE TOTAL %TBSA
Burns are classified according to the depth of injury and as a percentage of TBSA. More information on burn depth can be found here and more information regarding %TBSA burn assessment can be found here.
It is important to accurately document the location and area of the burn. The recommended tool for assisting in calculating this in adults is the Wallace rule of nines chart, in children the Lund Browder tool is used.
Palmar Method
In addition to the Wallace Rule of Nines and the Lund and Browder assessment tools, the Palmer surface of the patients hand (including palm and fingers) is equivalent to 1% TBSA