lund and browder chart

3 min read 18-03-2025

The Lund and Browder chart is a crucial tool in the medical field, specifically within the realm of burn care. It provides a quick and accurate method for estimating the total body surface area (TBSA) affected by burns. This is vital for determining the severity of the burn, guiding treatment decisions, and predicting patient outcomes. Understanding how to use this chart is essential for healthcare professionals involved in burn management.

Understanding the Lund and Browder Chart

The Lund and Browder chart differs from other TBSA estimation methods like the "rule of nines" because it accounts for the proportional changes in body surface area as a person grows. Unlike the rule of nines, which uses fixed percentages for different body regions, the Lund and Browder chart uses age-specific percentages. This makes it significantly more accurate, particularly in children, where body proportions are drastically different from adults.

How the Chart Works

The chart presents a diagram of the human body, divided into various sections. Each section has a corresponding percentage representing its proportion of the total body surface area for different age groups (infant, child, adult). To use the chart:

Identify the Age Group: Find the correct age-specific chart.
Assess Burn Depth and Location: Determine the depth (superficial, partial-thickness, or full-thickness) and location of each burn.
Calculate Percentage: For each burned area, estimate the percentage of that specific body region affected.
Sum the Percentages: Add the percentages of all affected areas to obtain the total TBSA burned.

Advantages of Using the Lund and Browder Chart

Increased Accuracy: The age-specific percentages make it significantly more accurate than the rule of nines, especially in children.
Detailed Assessment: Allows for a more precise estimation of TBSA, considering the specific location and size of burns.
Improved Treatment Planning: Accurate TBSA estimation is essential for fluid resuscitation, wound care, and overall burn management.
Better Outcome Prediction: The chart helps healthcare professionals predict the severity of the burn and potential complications.

Limitations of the Lund and Browder Chart

Despite its advantages, the Lund and Browder chart also has limitations:

Subjectivity: Estimating the percentage of burned area in each body region can be subjective, requiring experience and skill.
Difficult in Irregular Burns: Accurate estimation can be challenging with irregularly shaped burns.
Requires Chart Access: The chart must be readily available for use.

Frequently Asked Questions (FAQs) about the Lund and Browder Chart

What is the difference between the Lund and Browder chart and the Rule of Nines?

The Rule of Nines uses fixed percentages regardless of age, making it less accurate, particularly in children. The Lund and Browder chart uses age-specific percentages, leading to a more precise TBSA estimation.

How accurate is the Lund and Browder Chart?

The Lund and Browder chart offers improved accuracy compared to the Rule of Nines, particularly in children. However, some subjectivity remains in estimating burn percentages.

Is the Lund and Browder chart used for all types of burns?

Yes, the Lund and Browder chart is applicable for various burn types, including thermal, chemical, and electrical burns. The assessment of depth and location remains critical.

Who uses the Lund and Browder chart?

Emergency medical technicians (EMTs), paramedics, nurses, physicians, and other healthcare professionals involved in burn care utilize the Lund and Browder chart.

Conclusion

The Lund and Browder chart is a valuable tool for accurately estimating TBSA in burn patients. Its age-specific percentages provide a significant improvement over the Rule of Nines, resulting in more precise treatment planning and improved patient outcomes. While some subjectivity remains, understanding and proper use of this chart are crucial for effective burn management. Always remember that this chart is just one piece of the assessment puzzle, and clinical judgment remains paramount in burn care.