Medical Surgical Critical Care Burns #1

Question

A client comes into the Emergency Department (ED) with full-thickness electrical burns covering the hands, arms, and frontal trunk. According to the Rule of 9’s, what is the client’s total body surface area (TBSA)?

Answers

  1. 18% TBSA
    • Rationale:

      This answer is not correct because the burn covers the hands, arms, and frontal trunk, the total percentage burned is 36%. Each hand and arm are 9%, so since both hands and arms were included, that is a total of 18%, and the frontal or anterior trunk is 18%. 18% + 18% = 36% total body surface area burned.

  2. 25% TBSA
    • Rationale:

      This answer is not correct because the burn covers the hands, arms, and frontal trunk, the total percentage burned is 36%. Each hand and arm are 9%, so since both hands and arms were included, that is a total of 18%, and the frontal or anterior trunk is 18%. 18% + 18% = 36% total body surface area burned.

  3. 30% TBSA
    • Rationale:

      This answer is not correct because the burn covers the hands, arms, and frontal trunk, the total percentage burned is 36%. Each hand and arm are 9%, so since both hands and arms were included, that is a total of 18%, and the frontal or anterior trunk is 18%. 18% + 18% = 36% total body surface area burned.

  4. 36% TBSA
    • Rationale:

      This answer is correct because the burn covers the hands, arms, and frontal trunk, the total percentage burned is 36%. Each hand and arm are 9%, so since both hands and arms were included, that is a total of 18%, and the frontal or anterior trunk is 18%. 18% + 18% = 36% total body surface area burned.

Overview

The rule of 9’s divides the body into percentages. The total body surface area (TBSA) is how much of the total body was burned.

Explanation

Learning Outcomes

The rule of 9’s divides the body into percentages. Each arm including each hand is 9% each; the anterior trunk is 18%; posterior trunk is 18%; the head and neck are 9%, perineum or genitalia is only 1%; and legs with the feet are 18% each. The total body surface area (TBSA) is how much of the total body was burned. A full-thickness burn penetrates all the skin layers, which include the epidermis, the dermis, through the subcutaneous layer, muscle, and even bone.

Test Taking Tip

Know the “Rule of 9’s” to determine the total body surface area (TBSA) for burns. These will be on NCLEX.

Video Rationale