The Difference in TBSA Estimation Between Emergency Room and Burn Unit in Second Tier Hospital in Central Jakarta
DOI:
https://doi.org/10.14228/jprjournal.v8i1.310Keywords:
Burn Injury, TBSA EstimationAbstract
Introduction: Burn TBSA estimation is essential to administer fluid resuscitation. There are some methods, including Rule of 9 and Lund-Browder Chart. This study aims to identify the difference in TBSA estimation in Emergency Room & Burn Unit.
Method: We conducted a retrospective cross-sectional study in design. The Inclusion criteria are patients admitted to the Jakarta Islamic Hospital Cempaka Putih (JIHCP) burn unit between April 2015-September 2018, acute patients who have complete demographic data, complete TBSA estimation in the emergency room (ER) and burn unit (BU). Exclusion criteria are patients who do not have complete demographical data and incomplete TBSA estimation between the emergency room and burn unit. The estimation of TBSA in the emergency room is done by General Practitioner, while in the burn unit is done by Plastic Surgeon.
Result: Of all 160 patients admitted, 142 patients are eligible in the inclusion criteria. Most of it was adult males with an average of 28.3 years old, suffering a grade II burn injury caused by scald. There is a higher mean of TBSA estimation in the Emergency room with 15.83 (SD 12.21) compared to the Burn Unit with 12.92 (SD 12.00). The maximum TBSA overestimation in ER reaches 24% TBSA than BU, while the minimum is 0.5%. The Maximum TBSA underestimation in ER reaches 20% TBSA than BU, while the minimum underestimation is also 0.5%. On average, ER overestimates about 6.7% TBSA and underestimates about 2.8% TBSA compared to BU.
Conclusion: The emergency room tends to overestimate the TBSA, with an almost 3% difference in mean (p<0.05). There is an occurrence of a maximum 24% TBSA overestimation while averaging 6.7% TBSA.
References
Armstrong JR, Willand L, Gonzalez B, Sandhu J, Mosier MJ. Quantitative Analysis of Estimated Burn Size Accuracy for Transfer Patients. J Burn Care Res. 2017;38:e30–5.
Dolp R, Rehou S, McCann MR, Jeschke MG. Contributors to the length-of-stay trajectory in burn-injured patients. Burns [Internet]. 2018;44:2011–7. Available from: https://doi.org/10.1016/j.burns.2018.07.004
Face S, Dalton S. Consistency of total body surface area assessment in severe burns: Implications for practice. EMA - Emerg Med Australas. 2017;29:429–32.
Swords DS, Hadley ED, Swett KR, Pranikoff T. Total body surface area overestimation at referring institutions in children transferred to a burn center. Am Surg. 2015;81:56–63.
Taylor SL, Sen S, Greenhalgh DG, Lawless MB, Curri T, Palmieri TL. Not all patients meet the 1 day per percent burn rule: A simple method for predicting hospital length of stay in patients with burn. Burns [Internet]. 2017;43:282–9. Available from: http://dx.doi.org/10.1016/j.burns.2016.10.021
Harish V, Raymond AP, Issler AC, Lajevardi SS, Chang LY, Maitz PKM, et al. accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: An audit of 698 patients. Burns [Internet]. 2015;41:91–9. Available from: http://dx.doi.org/10.1016/j.burns.2014.05.005
Redlarski G, Palkowski A, Krawczuk M. Body surface area formulae: An alarming ambiguity. Sci Rep [Internet]. 2016;6:1–8. Available from: http://dx.doi.org/10.1038/srep27966
Redlarski G, Palkowski A, Krawczuk M. A systematic review of burn injuries in low- and middle-income countries: Epidemiology in the WHO-defined African Region. Sci Rep. 2016;6:1–8.
Belie O, Mofikoya BO, Fadeyibi IO, Ugburo AO, Buari A, Ugochukwu NN. Cooking gas explosions as cause of burns among patients admitted to a regional burn centre in Nigeria. Ann Burns Fire Disasters. 2020;33:62–8.
Wachtel TL, Berry CC, Wachtel EE, Frank HA. The inter-rater reliability of estimating the size of burns from various burn area chart drawings. Burns. 2000;26:156–70.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Aditya Wardhana, Gammaditya A. Winarno, Sanjaya F. Tanjunga, An’umillah Arini Zidna, Amani S. Augiani
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain the copyright of the article and grant Jurnal Plastik Rekonstruksi the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License. Articles opting for open access will be immediately available and permanently free for everyone to read, download and share from the time of publication. All open access articles are published under the terms of the Creative Commons Attribution-Non-commercial-NoDerivatives (CC BY-NC-ND) which allows readers to disseminate and reuse the article, as well as share and reuse of the scientific material. It does not permit commercial exploitation or the creation of derivative works without specific permission.