Question

A client is admitted with burns of the right arm, chest, and head. According to the Rule of Nines, the percent of burn injury is: A. \(18 \%\) B. \(27 \%\) C. \(36 \%\) D. \(45 \%\)

Short answer

Question: Using the Rule of Nines, calculate the percentage of burn injury on an adult covering the right arm, chest, and head. A. 18% B. 27% C. 36% D. 45% Answer: B. 27%

Step-by-step solution

Identify the burned body parts and their percentages using the Rule of Nines

According to the Rule of Nines, the body is divided into sections with each representing a percentage of TBSA: - Head: 9% - Chest (front part of the torso): 9% - Right arm: 9%

Add the percentages of the burned body parts

Now, we will add up the percentages of the burned sections together to find the total percentage of the burn injury: 9% (Head) + 9% (Chest) + 9% (Right arm) = 27%

Choose the correct option

The total percentage of the burn injury is \(27 \%\). Therefore, the correct answer is option B. \(27 \%\).

Key concepts

Rule of Nines

The "Rule of Nines" is a method used by healthcare professionals to estimate the total body surface area (TBSA) affected by burns. This rule simplifies the assessment by dividing the body into sections, each representing 9% (or multiples thereof) of the TBSA. This makes it easier to quickly calculate the extent of a burn injury, particularly in emergency situations.

For adults, the divisions are generally as follows:

• Head and neck: 9%
• Each arm: 9%
• Each leg: 18%
• Anterior torso: 18% (chest and abdomen)
• Posterior torso: 18%
• Perineum: 1%

The Rule of Nines is a simple and quick method but is not perfect. It tends to overestimate the TBSA in children or individuals with atypical body proportions. For children, modifications are necessary, such as the Lund and Browder chart, which provides more specific calculations.

Total Body Surface Area (TBSA)

Total Body Surface Area (TBSA) is a crucial concept in assessing burn injuries. It represents the entire skin surface area of an individual and plays a significant role in determining the severity of burns and guiding treatment decisions.

TBSA is measured as a percentage to indicate how much of the skin is affected by the burn. It helps in calculating fluid resuscitation needs, determining the need for specialized care, and predicting outcomes. For instance, burns affecting more than 10% of TBSA in children or 20% in adults typically require hospital admission.

Accurate estimation of TBSA aids in developing an effective treatment plan and deciding on interventions, such as skin grafts, physical therapy, and wound care.

Burn Injury Calculation

The calculation of burn injury percentage using the Rule of Nines is straightforward but essential for immediate treatment protocol decisions. Suppose a person sustains burns on their head, chest, and right arm. Utilizing the Rule of Nines, each of these areas contributes 9% to the total burn coverage. Therefore, they collectively account for 27% of the TBSA.

Steps to calculate with the Rule of Nines:

• Identify each affected body part and its corresponding TBSA percentage based on the Rule of Nines.
• Add these percentages together to find the overall burn extent.

In our example, the percentages are:

• Head: 9%
• Chest: 9%
• Right arm: 9%
• Total: 27%

Understanding how to perform a burn injury calculation reliably is critical in the quick assessment and response to such traumas, enabling proper care and resource allocation.