ADULT BURNS ASSESSMENT MAHARAJ NAKORN CHIANG MAI HOSPITAL

Name of patient : ______________________________________________ Age : ___________ Sex : _____________

HN : ___________ Date : __________ Time : ______ Admit weight : ___________ Admit height : ______________
Mechanism of injury : _______________________________________________________________________________

KEY :
Partial thickness burn (PT)
Full thickness burn (FT)

REGION PT % FT %
Head
Neck
Ant. Trunk
Post. Trunk
Right arm
Left arm
Buttocks
Genitalia
Right leg
Left leg
Total burn
คักลอกภาพจาก: https://intermediate.frcemsuccess.com/lund-browder_chart-burn_injury/

FLUIDS : Resuscitation fluids for deep partial and full-thickness burns larger than 20% TBSA
Flame or Scald burn : 2 mL x BW(kg) ______ x % TBSA _______ = Total fluid in 24 hours _________ mL
Electrical injury : 4 mL x BW(kg) ______ x % TBSA ______ = Total fluid in 24 hours __________ mL

Total fluid in 24 hours __________ /2 = Volume in first 8 hours since burn __________ mL
Volume in next 16 hours since burn __________ mL
TARGET URINE OUTPUT :
Flame or Scald burn : 0.5 mL/kg/hr Electrical injury : 1-1.5 mL/kg/hr until urine clears
Staff/ Resident/ Intern/ Medical student : _________________________ (Signature)
 PEDIATRIC BURNS ASSESSMENT MAHARAJ NAKORN CHIANG MAI HOSPITAL
Name of patient : ______________________________________________ Age : ___________ Sex : _____________
HN : ___________ Date : __________ Time : ______ Admit weight : ___________ Admit height : ______________
Mechanism of injury : _______________________________________________________________________________

KEY :
Partial thickness burn (PT)
Full thickness burn (FT)

คัดลอกรูปภาพจาก: http://veturecapitaltrust.co/lund-bowder-burn-diagram.html

FLUIDS : Resuscitation fluids for deep partial and full-thickness burns larger than 20% TBSA

Flame or Scald burn :

≥ 14 years old : 2 mL x BW(kg) ______ x % TBSA _______ = Total fluid in 24 hours __________ mL

< 14 years old : 3 mL x BW(kg) ______ x % TBSA _______ = Total fluid in 24 hours __________ mL
Infants and young children (≤ 30 kg) : 3 mL x BW(kg) ______ x % TBSA _______
= Total fluid in 24 hours __________ mL (plus a sugar-containing solution at maintenance rate)

Electrical injury : 4 mL x BW(kg) ______ x % TBSA ______ = Total fluid in 24 hours __________ mL

Total fluid in 24 hours __________ /2 = Volume in first 8 hours since burn __________ mL

Volume in next 16 hours since burn __________ mL

TARGET URINE OUTPUT : Electrical injury : 1-1.5 mL/kg/hr until urine clears
Flame or Scald burn : ≥ 14 years old : 0.5 mL/kg/hr < 14 years old and infants : 1 mL/kg/hr
Staff/ Resident/ Intern/ Medical student : _________________________ (Signature)