Citation

Malkoff N, Cannata B, Wang S, Manasyan A, Maestas J, Pickering TA, Koegler L, Kashani S, Johnson M, Yenikomshian HA, Gillenwater TJ. J. Burn Care Res. 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/irae117

PMID

39037208

Abstract

The percent total body surface area burned is a critical determinant of the required level of care, initial management, and prognosis in burn patients. The current gold standard for estimating this measurement, the Lund-Browder chart, requires familiarity with its construction and may not be practical for use by first responders in the field. In this study, we present a novel burn surface area calculator mobile application developed for first responders and validate its accuracy. Infant, pediatric, and adult manikins were fabricated with eight simulated burns of varying sizes and distributions. 42 pre-clinical medical students and firefighters were tasked with estimating the total body surface area of each burn using both the FireSync-EMS app and Lund-Browder chart. Univariate analysis and mixed-effects linear regression modeling were performed to compare the accuracy of both methods in relation to user experience, manikin size, and burn size. FireSync-EMS significantly reduced overestimation bias (0.11%, SD 2.33 versus 0.91%, SD 4.12, p = 0.002), particularly for burns on child-size manikins (p < 0.001) and burns involving <10% (p = 0.005) and >20% (p = 0.030) total body surface area. Multivariable modeling revealed that the Lund-Browder chart was an independent determinant of the magnitude of estimation error, with a 1.19 times multiplicative effect relative to FireSyncEMS (p < 0.001). Participants overwhelmingly found FireSync-EMS easier, more intuitive, faster, and preferable (p < 0.001 for all). FireSync-EMS may be an easier, faster, and more accurate alternative to the Lund-Browder chart for estimation of the total body surface area burned.

Language: en

Keywords

burns; clinical assessment; emergency responders; mobile application