Changing the Way We Think About Burn Size Estimation

Gillenwater, T Justin; Collier, Zachary J; Gillenwater, Justin

doi:10.1093/jbcr/iry050

Cited by 42 publications

(24 citation statements)

References 42 publications

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“…This often happens in patients with burn area <20 % as opposed to larger burn areas as evidenced by the study by Pham et al 12 Computer-based burn analysis can be useful in the assessment of TBSA rather than estimation by using palm, hand, or Rule of 9s, as these tools do not take into consideration the patient body mass index, race, age, and sex. 12 Along with the presence of facial burns, stridor, difficulty in breathing, singed nasal hairs, cough, soot in the oral cavity, and fire in an enclosed space should be considered as strong indicators for early intubation. 13 As such, no consensus/ scoring system exists for intubation in inhalational injury.…”

Section: Resultsmentioning

confidence: 99%

Initial assessment of mortality rates of burn patients in a tertiary care hospital by total body surface area, depth and facial burns, and its correlation with serial total leucocyte count

Balachandran¹,

Nirmalanandan²

2020

Int Surg J

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Background: The pattern of burns in victims varies with the manner of infliction of burns. Age plays an important role in deciding the mortality and morbidity of burn victims. Other factors that decide the prognosis of burn victims are the total body surface area (TBSA), Depth of burns, and inhalational injury as evidenced by facial burns. Assessment of these epidemiological factors and inhalational injury can be done as a part of the initial evaluation. Such an assessment aid in resuscitation including emergent airway and decision making regarding the need for skin grafts or escharotomy. Serial measurement of total leucocyte count also helps in identifying the onset of infection and progress to septicaemia and increased mortality rates.Methods: As a part of the initial evaluation, we attempt to study the relation between TBSA, Depth of burns, facial burns, and total WBC count with mortality. A background of septicaemia was also noticed in the majority of patients.Results: For analysis, patients were divided into two groups- Survivors and Non-survivors. A fall in total WBC count coincided with the onset of sepsis and mortality. The other three factors also had a direct correlation with mortality rates.Conclusions: A scoring system constituting all the factors is essential as an initial diagnostic step and it will help in deciding early intubation, escharotomy, and aggressive fluid resuscitation.

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Section: Resultsmentioning

confidence: 99%

Initial assessment of mortality rates of burn patients in a tertiary care hospital by total body surface area, depth and facial burns, and its correlation with serial total leucocyte count

Balachandran¹,

Nirmalanandan²

2020

Int Surg J

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“…In treatment planning, particularly in estimating fluid replacement requirements, knowledge of the wound size is essential. It is well known among burn physicians that referring providers from outside hospitals often misestimate the TBSA of burns [12]. Few, if any, studies have assessed burn size estimation within the same institution.…”

Section: Discussionmentioning

confidence: 99%

Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists

Hahn

Roh

Price

et al. 2020

Cureus

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Introduction Correctly assessing burn size is extremely important since it is directly associated with a patient's subsequent management. Further, an accurate assessment of the total body surface area (TBSA) involved is crucial to decide if specialty care in a burn unit is necessary, whereby overestimation has the potential to lead to unnecessary patient transfers and undesirable burdens on the healthcare system and inconvenience to patients. The goal of this study was to identify whether burn injury estimates of TBSA percentage correlate between emergency department (ED) clinician and burn specialists. Methods This was a retrospective study conducted between February 1, 2018 and July 31, 2019 of patients with a burn injury who were evaluated by both an ED clinician and a burn specialist during the same ED visit. Charts were reviewed to identify the documentation of TBSA by prehospital personnel, ED nursing staff, ED mid-level providers (MLP), ED attending physicians, burn consultant MLPs, and burn consultant attending physicians. Results During the study period, 189 subjects with both an ED and burn consultant. The median age was 11 years [interquartile range (IQR) 1-49], and 103 (54%) were males. More than half of the subjects (n=106, 56%) were under the age of 18. There was a statistically significant correlation between estimates of TBSA between ED and burn consultants overall (p<0.0001). Furthermore, there was a statistically significant correlation between ED and burn MLPs (p<0.0001) as well as ED and burn attending physicians (p<0.0001). When adjusted for MLP and attending sex, there was still a correlation among all groups (p<0.0001). Conclusions In this study, there was a statistically significant correlation between estimates of TBSA between ED and burn consultants

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“…Retrospective data from multiple North American Burn Centers suggest that many patients referred for large injuries were actually discharged within 24 h. Up to 70% of patients referred with overestimated burn size were discharged within 48 h. Only 30% of referred patients required surgery. Many referred patients were more likely to have appropriate triage to a follow-up clinic rather than receiving direct transfer to the Burn Center [7]. International Burn Centers have reported similar experiences.…”

Section: Burn Size Evaluationmentioning

confidence: 92%

“…Growing evidence suggests that utilization of computer-based imaging technology is a more reliable and reproducible means to estimate burn size. Using computer technology, now available on mobile devices such as tablets, as a component of a telemedicine system, burn triage may be further enhanced [7,10]. Many burn providers suggest that a more robust telemedicine system may bring about a shift in referral-based burn care that will enhance the ability of initial providers to provide early management of the highest quality.…”

Section: Burn Size Evaluationmentioning

confidence: 99%

Burn care: before the burn center

Dries

2020

Scand J Trauma Resusc Emerg Med

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Changing the Way We Think About Burn Size Estimation

Cited by 42 publications

References 42 publications

Initial assessment of mortality rates of burn patients in a tertiary care hospital by total body surface area, depth and facial burns, and its correlation with serial total leucocyte count

Initial assessment of mortality rates of burn patients in a tertiary care hospital by total body surface area, depth and facial burns, and its correlation with serial total leucocyte count

Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists

Burn care: before the burn center

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