Using the 'rule of nine', estimated burn size in an adult having burn injury to chest and stomach is per cent?

Appeared in: AIIMS Patna NO - 2020

Explanation

The 'Rule of Nines' is a quick method to estimate the total body surface area (TBSA) of a burn in adults.
It divides the body into sections, each representing approximately 9% or a multiple of 9% of the TBSA.
The anterior trunk, which includes the chest and the stomach (abdomen), is allocated a total of 18%.
This is calculated as 9% for the chest and 9% for the abdomen, so a burn to both areas equals 18%.

Option B: A burn of 27% would involve more body surface area than just the chest and stomach.
Option C: A burn of 36% represents a much larger area than the anterior trunk alone.
Option D: A burn of 9% would only account for either the chest or the stomach, but not both.

Clinical Relevance

Nursing practice connection: Knowing Rule of Nines for Burn Assessment helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Accurate TBSA estimation is the first step in calculating intravenous fluid requirements using formulas like the Parkland formula (4 mL of Lactated Ringer's × patient's weight in kg × %TBSA).
In adults, burns covering more than 15-20% of TBSA necessitate aggressive fluid resuscitation to prevent burn shock, a form of hypovolemic shock.
What if? If the patient were an infant or young child, the 'Rule of Nines' would be inaccurate due to their different body proportions (a proportionally larger head and smaller legs). In pediatrics, the Lund-Browder chart is the more accurate and recommended tool for TBSA estimation.

How to Approach the Question

First, identify the specific assessment tool mentioned in the question, which is the 'Rule of Nines'.
Next, note the patient's age group, which is an 'adult'. This is critical because the percentages differ for children.
Identify the body parts involved in the burn: the 'chest' and 'stomach'.
Recall the TBSA percentages for an adult using the Rule of Nines. The entire front (anterior) torso is 18%.
Break down the anterior torso into its components: the chest is 9% and the abdomen (stomach area) is 9%.
Sum the percentages for the affected areas: 9% (chest) + 9% (stomach) = 18%. Select the option that matches this calculation.

Concept Tested & Keywords

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

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