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The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected. It was created by Dr. Charles Lund, Senior Surgeon at Boston City Hospital, and Dr. Newton Browder, based on their experiences in treating over 300 burn victims injured at the Cocoanut Grove fire in Boston in 1942.
The Wallace rule of nines is a tool used in pre-hospital and emergency medicine to estimate the total body surface area (BSA) affected by a burn.In addition to determining burn severity, the measurement of burn surface area is important for estimating patients' fluid requirements and determining hospital admission criteria.
In burn cases that involve partial body areas, or when dermatologists are evaluating the Psoriasis Area and Severity Index (PASI) score, the patient's palm can serve a reference point roughly equivalent to 1% of the body surface area. For children and infants, the Lund and Browder chart is used to assess
Recent analysis of mortality in burn units worldwide has shown that for well performing units the LD50 (the point at which 50% of patients would be expected to die) for major burns has significantly improved and the best units have a modified Baux score of 130-140. This means that all burns in children (except 100% TBSA full-thickness burns ...
For example, a person weighing 75 kg with burns to 20% of his or her body surface area would require 4 x 75 x 20 = 6,000 mL of fluid replacement within 24 hours. The first half of this amount is delivered within eight hours from the burn incident, and the remaining fluid is delivered in the next 16 hours.
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