AI-based burn assessments could relieve patient suffering

The priority assessment for a burn patient involves the ABCs of emergency care (Airway, Breathing, Circulation) and a focused evaluation of the burn injury. Ensure a patent airway and adequate breathing, as burns to the face or airway can cause swelling and compromise the air passage. Assess circulation, including pulse and skin perfusion, as severe burns can lead to fluid loss and shock. Evaluate the extent and depth of the burn, as well as any associated injuries. It’s crucial to quickly determine the percentage of total body surface area affected and the depth of the burn in order to guide fluid resuscitation and initial management. Additionally, assess for any signs of inhalation injury if there has been exposure to smoke or fire. Early and thorough assessment is vital in guiding the immediate care and subsequent treatment of a burn patient.

The functional assessment of burns involves evaluating the patient’s physical and psychosocial functioning to guide treatment and rehabilitation. This assessment includes both subjective and objective measures. Subjective assessment encompasses factors such as inhalation injury, total body surface area (TBSA) affected, burn type and depth, burn site, past and present history, social support, and emotional well-being. Objective assessment involves evaluating pain intensity, burn outcome measures, inhalation assessment, edema assessment, and physical assessment, including the impact on activities of daily living, mobility, strength, flexibility, endurance, and psychological well-being. The Functional Assessment for Burns (FAB) score is a valuable tool for objectively measuring the physical function and predicting the discharge outcome in burn patients, including critically ill individuals ^3,4,5.

The documentation of a burn assessment is crucial for successful treatment and should include key factors such as burn depth, size, location, and other relevant details. It is important to document the type of burn (thermal, chemical, electrical, or radiation), the extent of the burn expressed as a percentage of total body surface area (TBSA), the depth of the burn (e.g., first degree, partial thickness, or full thickness), and specific patient characteristics such as age, medical history, and associated injuries. Anatomical locations should be documented with laterality and the specific part of the body involved. Additionally, it is essential to use a relatively comprehensive documentation system to ensure quality patient care, including electronic documentation systems that offer enhanced quality, reduced errors, and faster access to data^6,7. Accurate burn size assessment is crucial, and various methods such as the Lund Browder Chart, Rule of Nines, or Rule of Palms can be used to estimate the percentage of TBSA affected by a burn injury.

The rule of nines is a quick method to assess the extent of burn injury in adults. It divides the body into sections, with each area representing a specific percentage of the total body surface area (TBSA) affected by the burn. The areas and their respective percentages are as follows:

• 9% for both the anterior and posterior surfaces of the head and neck
• 9% for both the anterior and posterior surfaces of each upper limb (18% for both)
• 18% for the anterior trunk, 18% for the posterior trunk (36% for both)
• 9% for the anterior surface, 9% for the posterior surface of each lower limb (18% for both)
• 1% for the perineum

The rule of nines is a valuable tool used by healthcare professionals to assess TBSA involvement in burn patients, aiding in estimating fluid resuscitation requirements and guiding initial management 8,9.