Lack of precision of burn surface area calculation by UK Armed Forces medical personnel

Abstract

Objective: Accurate determination of the severity of burn is essential for the care of thermally injured patients. We aimed to examine the accuracy and precision of TBSA calculation performed by specialist military burn care providers and non-specialist but experienced military clinicians.

Methods: Using a single case example with photographic montages and a modified Lund and Browder chart, the two cohorts of clinicians were each given 10min to map and calculate the case example TBSA involvement. The accuracy and precision of results from the two cohorts were compared to a set standard %TBSA.

Results: The set standard %TBSA involvement was 64.5%. Mean %TBSA mapped by non-specialists (52.53±10.03%) differed significantly from the set standard (p<0.0001). No difference was observed when comparing results from the burn care providers (65.68±10.29%; p=0.622). However, when comparing precision of calculation of TBSA burned, there was no evidence of a difference in heterogeneity of results between the two cohorts (F test, p=0.639; Levene's test, p=0.448).

Conclusions: These results indicate that experienced military burn care providers overall more accurately assess %TBSA burned than relatively inexperienced clinicians. However, results demonstrate a lack of precision in both groups.

Keywords: Accuracy; Burn wound mapping; Military burns; Precision.