GMCH Chandigarh - 2019
Child Health Nursing (Pediatrics)
Easy
A 4-year-old female child suffered severe burns in a house fire. How will you examine the extent of her burns?
Appeared in: GMCH Chandigarh - 2019
Explanation
- The Lund and Browder chart is the most accurate method for estimating the Total Body Surface Area (TBSA) of burns in children.
- It is specifically designed to account for the variation in body proportions at different ages, such as the proportionally larger head and smaller limbs in young children compared to adults.
- Accurate TBSA calculation is crucial for determining fluid resuscitation volumes, guiding treatment decisions, and deciding on the need for transfer to a specialized burn unit.
Why Other Options Were Wrong
- Option A: The Parkland formula is used to calculate the volume of resuscitation fluid required over 24 hours, not to measure the percentage of TBSA.
- Option C: Hartman's formula is not a standard tool for burn assessment. The name likely refers to Hartmann's solution (Lactated Ringer's), an IV fluid used for resuscitation.
- Option D: The rule of tens is a simplified method for estimating initial fluid rates in adult burn patients and is not used for assessing burn extent or for pediatric patients.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment of Burn Extent in Children as background academic context rather than a clinical decision trigger.
- Accurate TBSA assessment in children is critical because their lower body mass puts them at higher risk for dehydration and hypothermia.
- An incorrect TBSA estimation can lead to either under-resuscitation (causing shock and organ damage) or over-resuscitation (causing pulmonary edema and compartment syndrome).
- For children, partial-thickness burns covering more than 10% TBSA typically require formal fluid resuscitation and referral to a specialized burn center.
How to Approach the Question
- First, identify the core of the question: it asks for a method to 'examine the extent' of burns.
- Recognize that 'extent' in the context of burns refers to the Total Body Surface Area (TBSA) percentage.
- Note the patient's age: a 4-year-old child. This is a key piece of information, as assessment methods can differ between children and adults.
- Evaluate each option: 'By using the Lund and Browder chart' is a known method for TBSA assessment, especially in pediatrics.
- Analyze the distractors: The 'Parkland formula' and 'Rule of tens' are related to fluid calculation, not TBSA assessment. 'Hartman's formula' is not a standard burn tool and likely refers to an IV solution.
- Conclude that the Lund and Browder chart is the only option presented that is a primary tool for accurately assessing burn extent in a child.
Concept Tested & Keywords
- Concept Tested: Assessment of Burn Extent in Children
- Stem keywords: 4-year-old, child, severe burns, examine the extent
- Lead-in keywords: How
- Clinical cues: Patient is a 4-year-old child, which is a critical factor in choosing the assessment method.
Question ID
Q5iiSB3B9bjo-gzNpq5pK0
Reference Book
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 693-695
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 747-749
Practise the full GMCH Chandigarh - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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