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THE
RULE OF NINES
Assessment
of burn size using the ‘rule of nines’ whereby body
surface area is divided into areas of 9% or 18% of total
Assessment in children requires a modification of the
adult normogram.
The magnitude of
the fluid shifts and fluid requirements is evident
after a successful resuscitation in a large burn
Urine output of
0.5-1 cc/kg/hr is an excellent marker of adequate
resuscitation
MAINTAINING
PERIPHERAL PERFUSION: ESCHAROTOMY
Deep
circumferential burn to arm and wrist. If
decreasing pulse on Doppler signal need to perform
escharotomy.
Escharotomy
incision on lateral and medial surface.
Incision must go thru the entire depth of
the burn to allow tissue expansion and a
return of blood flow.
Escharotomy being performed on lower leg and foot. Note
dark color of blood reflecting the stasis from the
constricting burn. Control bleeding with hand held
Cautery and pressure.
Escharotomy
of leg. Incision crosses the joint. Note wide
expansion of incision due to complete division of the
burn eschar.
