When a patient is brought to the emergency unit with burns, one of the first things the medical team will need to assess is the total body surface area (TBSA) that has been burned. This information is essential for determining the severity of the burn and the patient’s fluid resuscitation needs.
One of the most common methods for estimating TBSA burned is the Rule of Nines. This method divides the body into nine areas, each of which represents a percentage of the total body surface area. The percentages are as follows:
- Head and neck: 9%
- Each arm: 9%
- Anterior trunk: 18%
- Posterior trunk: 18%
- Each leg: 18%
- Genitalia: 1%
To estimate the TBSA burned using the Rule of Nines, the medical team will visually assess the burn and determine the percentage of each body area that is affected. They will then add up the percentages for each body area to get the total TBSA burned.
A client is brought to the emergency unit with third-degree burns on the posterior trunk, right arm, and left posterior leg. Using the Rule of Nines, what is the total body surface area (TBSA) that has been burned?
The posterior trunk represents 18% of the TBSA, the right arm represents 9% of the TBSA, and the left posterior leg represents 9% of the TBSA. Therefore, the total TBSA burned is:
18% + 9% + 9% = 36%
Therefore, the client has sustained a 36% TBSA burn. This is a severe burn and will require aggressive fluid resuscitation and supportive care.
Third-degree burns are the most severe type of burn. They damage all layers of the skin, including the epidermis, dermis, and subcutaneous tissue. Third-degree burns often appear white or charred and may be numb.
Third-degree burns are very painful and require immediate medical attention. Treatment for third-degree burns typically involves debridement of the burned tissue, skin grafting, and supportive care.
The Rule of Nines is a quick and easy way to estimate the TBSA burned in a patient with burns. This information is essential for determining the severity of the burn and the patient’s fluid resuscitation needs.