How to determine the body surface area of a burn is vital during the initial management of treating burn victims. The measurement of burn surface area is important during the initial management of treating victims with burns for estimating fluid requirements and determining need for transfer to an emergency burns unit. The extent of injury is best described using the percentage of the total body surface area (%TBSA) that is affected by a burn. 

The “rule of palm” is one way to estimate the size of a burn.

HOW TO DETERMINE THE TBSA USING THE “RULE OF PALM”

  • The palm of the person who is burned is about 1% of the body.
  • This excludes the fingers and wrist area.
  • Use the victim’s palm to measure their body surface area burned.
Rule of Palm is the palm of the patient  is equal to 1% Body Surface Area. this excludes the fingers and wrist.
Rule of Palm

Estimation errors related to and/or based on incorrect %TBSA assessments may affect clinical decision-making and, in the extreme, can result in either hypovolemic shock and cardiac failure (under-estimation) or abdominal/extremity compartment syndrome, pulmonary edema and electrolyte imbalance (over-estimation).

TIPS

  • With severe burn injuries (>50%TBSA) it maybe easier to calculate what isn’t burned then subtract it from 100 to get %TBSA burns
  • Use the “rule of palm” method to calculate %TBSA for smaller burns. Remember to always use the patients hand, not your own.
  • In the prehospital and emergency department setting, the %TBSA burns is more important than the depth of burn. %TBSA burns has indications for severity of injury, fluid resuscitation and transfer destination. Depth of the burn and burn wound progression becomes more significant after arrival at the Emergency Burn Unit as depth of burn will determine whether the burn can heal without surgical intervention, and how the Emergency Burn Unit will subsequently manage it.
  • If %TBSA burn estimation is inaccurate it has the potential to negatively impact fluid resuscitation by providing too much or too little fluid.

The first 24 hours after being burned are the most crucial, as a burn progresses and deepens over time. Applying Burnshield in the first 24 hours minimises damage.

BURNSHIELD KEY BENEFITS

  • Sterile
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  • Pain relief & shock reduction
  • Clear: easy to assess wound
  • Non-adherent
  • Natural anti-bacterial
  • Non toxic
  • Non irritant
  • 5 year shelf life

View our Burnshield product range here:

Available at your nearest leading pharmacy!

Resource: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396790/#B5; https://www.uofmhealth.org/;

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