Size Estimation Charts Series Of Round#

Size Estimation Charts Series Of Round

T 564 sp-16 Transparent chart for the estimation of defect size / 2. 4.2 The layout of the chart is shown in Figure 1. 4.1 Size estimation chart, a printed transparency approximately 9 by 14 cm of a series of round black spots and rectangles of various areas printed on a sheet of transparent plastic.

The rules of nine method, published by Wallace in 1951 as a simplification of measurements performed by Berkow in 1924 , is in common usage though overestimations are reported, especially in persons with high body mass index. This is also an inconvenient method to use for larger burns. The transparency can be used to measure spots, defects, or inclusions that range in size from 0.02 to 5.00 mm2.The patient palm method can lead to overestimations of 10% to 20% as area of the palmar surface of the adult hand corresponds to 0.78% of the BSA.

The method used for this assessment must be as robust, precise, reliable, and repeatable as possible.The process of calculating BSA burned using charts involves three stages. From the first responder to specialists, assessment of burn area may have to be conducted multiple times and by people with varying degrees of training and experience. Results may vary significantly among observers , and this variability is inversely proportional to accuracy. Estimates have to be made and mental calculations have to be performed, usually involving fractions, and can results in miscalculation. Using the LB chart itself is not easy, especially in emergency situations. Even though the LB chart ( Figure 1) is considered the most accurate of these three methods, it is still prone to errors.

In this modified chart, each region is subdivided into smaller areas such that each quadrilateral shape represents one-quarter of 1% (0.25%). These variable percentages are listed according to age in a separate table.The MLB chart (adult use only) used in this study ( Figure 2) was designed by the first author using the open source program (GNU Image Manipulation Program). For children, the head, thigh, and leg percentages vary with age and are designated as A, B, and C, respectively. The assessor draws an outline of the burn wound on the anterior and posterior body diagrams, calculates the burn area in each region, and then sums the area to obtain the body percentage of the burn wound. Major divisions of the body are demarcated by lines, and standard percentages of each part are indicated. Our experiment was deliberately simple and confined only to the third stage to determine which chart produces more consistent results.The LB chart ( Figure 1) consists of two outline drawings of the human body, anterior and posterior.

The interns were asked to calculate the burn percentage indicated on the charts. The charts were then administered randomly to 10 medical interns who had been briefed about the use of both charts before the experiment. Ten copies of each chart were prepared, giving a total of 100 charts. The number of shaded quadrilaterals is counted and divided by four to arrive at the total percentage of BSA burned.Five burn wounds of increasing percentage area (approximately 8%, 22%, 36%, 64%, and 76%) were shaded onto blank LB and MLB charts. As in the LB chart, the assessor colors in or outlines the burned area.

This consistency is because BSA is broken down into smaller measurable units, and there is no need to perform mental estimates or calculations with fractions. Assessors were uniform in their preference for the MLB chart due to its ease of calculation. At the end of the session, the interns were asked which chart was easier to complete.Our results show that results are significantly more consistent when assessors calculate burn percentage using the MLB chart compared to the LB chart. A two-sample t-test was conducted to show the statistical significance of differences in mean and variance between the two sets of estimates.

This calculation can usually be conducted mentally and the result obtained can be easily cross- and counterchecked. Each time the assessor performs estimation and calculation, there is potential for error.In the MLB chart, once the burn area is indicated, counting of squares and division by four is easy and requires no processing of fractions. Emergency situations are not conducive to accurate mathematical thinking, and errors can arise due to such miscalculations. This procedure has to be repeated for all affected regions and the total then calculated.

Further work needs to be address childhood variants of the MLB chart.