Assesment of burn

An approximate clinical rule in wide use is the rule of nines which acts on a rough guide to body surface area .As a rule an adult with more than 20 % of body surface area involved or a child  with more than  10 %  of body surface area involve will require intra venous fluid replacement .The prognosis depends upon the percentage of  body surface area burned . A rough guide is that if the age and percentage add together to a score of 100 then then the burn is likely to be fatal . A child may therefore survive a large burn but  even a small burn in an elderly patient is potentially fatal .

Intravenous access in a burned child may be difficult . Both rectal and intraosseous infusion (into upper third of tibia ) offer useful alternatives .