Rule of Nines question........

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Rule of Nines question........

I am confused!! :confused:

I would appreciate any help as I cannot work it out!!

I am doing a burns case study, and we have to work out the suface area of the burns the patient suffered. I know that the 'Rule of Nines' would be used, or the Lund and Browder chart, but I am still confused!?!

What I don't understand is in the rule of nines, if a person is burnt on both arms, would they get a '9', or an '18' % score? Or if they were only burnt on 1 arm, would they get a 4.5% score. I am soooo confused, I have looked in my texts, on the 'net, but nothing specifically states this. Thank you!

bew :)

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nines.GIF
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Not being a burn nurse, but an ER nurse, we just try to get a quick and dirty initial assessment of the burns.

A rule of nines chart is very helpful. Some charts use a 1 view with the total for the 1 arm being 9% (that is front and back).

something like this one: http://usitweb.shef.ac.uk/~mda00gcb/nines.htm

I prefer to use a chart where the front and back are seperate. This way the front of the arm is 4.5% and the back is 4.5%. I feel it gives a much more accurate assesment of the involvement.

something like this: http://www.webhealthcentre.com/general/fa_burns.asp

There are even charts that break down the areas even more... but I have rarely seen them.

To answer your question, if the patient had total involvement of bilat arms, he would score an 18%. But you also have to take into account how much of each area is burned. If only 1/2 of one arm was burned it would be 4.5%.

The thing to do is look at the chart, figure out the % the area that is burned, and then estimate the amount of burn (% of involvement) on that area.

At least that is the way that I estimate burns for an ER assessment, it gives a quick idea of how much involvement there is. And you must remember that the pediatric charts are diffeent from the adult one.

I hope I didn't make this even muddier for you.

bob

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Oh my gosh...I didn't mean it to be THAT big:confused:

Sorry Brian for taking up so much bandwith. Feel free anyone to make it smaller if anyone knows how:o

So Bewbew, if a person is burnt on both ams only he/she would score 18 %. The total body proportions add up to 100% as you see in this almighty big chart:D

This is for adults...the Lund Browder is used more commonly for kids as their head/neck area is bigger in proportion at that age.

Hope this helped;)

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My my I am still embarrassed about that huge chart lol:imbar

A good rule of thumb for a very quick assessment too is that your patient's palm equals approx 1% of total body surface.

BTW I am not a burns nurse either..so I happily bow to others if they are more informed or up to date than me.

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aus nurse:

DANG! Make a POINT or something!!! :chuckle

That was too freakin' hilarious! I can't stop laughing!:rotfl:

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my...what a handsome 1% he has....;)

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Thank you for the help............thanks for the BRILLIANT links, Bob, and thanks Ausnurse for the BIG diagram!!

I am still laughing too, and yes, sunnygirl272, it IS a handsome 1% !!!!!

bew :rotfl:

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You think some people (men) have more than just 1%:rolleyes:

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Oh my gosh-looks to me like the 1% MELTED!!!!!!!!!!!!!!!

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Originally posted by oldgirl

Oh my gosh-looks to me like the 1% MELTED!!!!!!!!!!!!!!!

lol..he shoulda used some of night owl's conditioner....

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Originally posted by aus nurse

My my I am still embarrassed about that huge chart lol:imbar

A good rule of thumb for a very quick assessment too is that your patient's palm equals approx 1% of total body surface.

BTW I am not a burns nurse either..so I happily bow to others if they are more informed or up to date than me.

Don't be embarrassed !! It's GREAT !! thanks:)

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