Burn size estimation in children: Still a problem
- 30 November 2011
- journal article
- research article
- Published by Wiley in Emergency Medicine Australasia
- Vol. 24 (2), 181-186
- https://doi.org/10.1111/j.1742-6723.2011.01511.x
Abstract
Accurate determination of burn size and depth forms an integral part of the initial assessment of any burn injury. Errors might lead to inaccurate fluid resuscitation and inappropriate transfer of patients to specialized burns units (BUs). Although recent data suggest some improvement in the estimation of burn injury in adults, this has not been shown in children. A retrospective review of children with burn injuries referred to the BU of our institution was performed. Data were collected from all patients presenting to the BU during the calendar year 2009. The total body surface area burned (TBSA-B) estimated by the referring centre was compared with the actual TBSA determined measured on arrival at the BU. Of the 71 paediatric patients referred during the study period, 10 did not have any TBSA-B estimation documented by the referring hospital. Inaccurate estimation of burn area was noted in 48 out of 61 patients (79%). Burn size was more likely to be overestimated than underestimated by a ratio of 2.2 to 1, especially in burns >10% TBSA-B (P= 0.002). Inaccurate estimation of burn size remains a problem in children. The persistent miscalculation of burn size might be a result of the various methods employed in assessing burn area, the inclusion of simple erythema and inadequate training or exposure of first responders. Accurate assessment of TBSA-B and burn depth in children remains elusive and would appear to require additional training and education.Keywords
This publication has 16 references indexed in Scilit:
- Early management of burns in childrenPaediatrics and Child Health, 2009
- Increased fluid resuscitation can lead to adverse outcomes in major-burn injured patients, but low mortality is achievableBurns, 2008
- Burn size determines the inflammatory and hypermetabolic responseCritical Care, 2007
- Effects of Differences in Percent Total Body Surface Area Estimation on Fluid Resuscitation of Transferred Burn PatientsJournal of Burn Care & Research, 2007
- Initial management of a major burn: II—assessment and resuscitationBMJ, 2004
- Early in‐hospital management of burn injuries in AustraliaAnz Journal of Surgery, 2004
- Transfers from Emergency Room to Burn CenterJournal Of Trauma-Injury Infection and Critical Care, 1987
- Comparison of Burn Size Estimates Between Prehospital Reports and Burn Center EvaluationsJournal of Burn Care & Rehabilitation, 1986
- Differences in Burn Size Estimates Between Community Hospitals and a Burn CenterJournal of Burn Care & Rehabilitation, 1982
- THE RULE OF NINESPlastic and Reconstructive Surgery, 1968