Among the following, which is the largest burn?

Appeared in: AIIMS Delhi NO-2016

Explanation

The 'Rule of Nines' is a standard method for estimating the Total Body Surface Area (TBSA) in adult burn victims.
According to this rule, a complete leg (both anterior and posterior surfaces) accounts for 18% of the TBSA.
This percentage (18%) is the highest value when compared to the other options provided.
A complete arm is 9%, the head and neck are 9%, and the anterior chest is 9%.

Option A: The anterior upper chest is only a portion of the anterior trunk. The entire anterior chest is valued at 9% TBSA, making the 'upper' portion even smaller.
Option B: The entire face and neck together are estimated as 9% of the TBSA in an adult, which is half the area of a full leg.
Option D: A complete left arm is estimated as 9% of the TBSA in an adult. This is equal to the head and neck but only half the area of a full leg.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Burn assessment using the Rule of Nines as background academic context rather than a clinical decision trigger.
Accurate TBSA estimation is critical for managing burn patients. It determines the volume of intravenous fluids needed for resuscitation, often calculated using formulas like the Parkland formula (4 mL x Body Weight in kg x %TBSA).
Incorrect TBSA estimation can lead to either under-resuscitation (risking hypovolemic shock and organ failure) or over-resuscitation (risking pulmonary edema and compartment syndrome).
The TBSA percentage also guides decisions on patient transfer to a specialized burn unit, wound care, and nutritional support.

How to Approach the Question

First, identify the core question, which is asking to compare the size of different body areas in the context of burns.
Recognize that this requires knowledge of a standardized method for estimating burn size, which is the 'Rule of Nines' for adults.
Recall or look up the TBSA percentages assigned to each major body part by the Rule of Nines.
Systematically apply these percentages to each option: Anterior chest (~9%), Face and neck (9%), Right leg (18%), Left arm (9%).
Compare the resulting percentages to identify the largest value.
Select the option corresponding to the largest percentage, which is the right leg.

Concept Tested & Keywords

Qfba7oWpjDbvU_1DGzDNKA

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 693-695

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