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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.
Total body surface area (TBSA) is an assessment of injury to or disease of the skin, such as burns or psoriasis. In adults, the Wallace rule of nines can be used to determine the total percentage of area burned for each major section of the body.
Rule of nines or rule of nine may refer to: Rule of nine (linguistics), an orthographic rule of the Ukrainian language. Rule of nines (mathematics), a test for divisibility by 9 involving summing the decimal digits of a number; Wallace rule of nines, used to determine the percentage of total body surface area affected when assessing burn injuries
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 original Baux score was the addition of two factors, the first being the total body surface area affected by burning (usually estimated using the Wallace rule of nines, or calculated using a Lund and Browder chart) and the second being the age of the patient. The score is expressed as:
Most burns (70%) involve less than 10% of the TBSA. [4] There are a number of methods to determine the TBSA, including the Wallace rule of nines, Lund and Browder chart, and estimations based on a person's palm size. [11] The rule of nines is easy to remember but only accurate in people over 16 years of age. [11]
The Parkland formula, also known as Baxter formula, is a burn formula developed by Charles R. Baxter, used to estimate the amount of replacement fluid required for the first 24 hours in a burn patient so as to ensure the patient is hemodynamically stable.
The Injury Severity Score (ISS) is an established medical score to assess trauma severity. [1] [2] It correlates with mortality, morbidity and hospitalization time after trauma. It is used to define the term major trauma. A major trauma (or polytrauma) is defined as the Injury Severity Score being greater than 15. [2]