Evaluating burn severity by assessing depth and the %TBSA burns is and important step during the head-to-toe examination. This assessment will:
A burn injury encompassing the entire back is 18% TBSA in an adult
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- 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.
Each leg is equivalent to 18%TBSA in adults. This is a 36% injury already without assessing upper body
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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
The Palmar Surface of the patients hand is equivalent to 1%TBSA
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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
