NREMT Paramedic Cognitive ExamTraumaHard
A 4-year-old child presents with full-thickness burns to both legs. Using the Lund-Browder chart, which of the following is the most accurate estimation of the total body surface area (TBSA) affected by these burns?
- A18%
- B27%
- C36%
- D32%
Show answer & explanationAnswer & explanation
Correct answer: D. 32%
The Lund-Browder chart is more accurate for children, accounting for their larger head and smaller legs relative to adults. For a 4-year-old, each leg is approximately 16% TBSA. Therefore, both legs would be 16% + 16% = 32%.
Why the other options are wrong
- A. 18% would be either the entire trunk or less than two legs for a child.
- B. 27% is not a standard Lund-Browder value for two legs in a 4-year-old.
- C. 36% would be the adult Rule of Nines for both legs, which overestimates in children.
Lund-Browder Chart
A more accurate method for estimating burn total body surface area (TBSA) in children, which adjusts for age-related proportional differences in body regions (e.g., larger head, smaller legs in infants/young children).
- More precise than the Rule of Nines for pediatric burns.
- Accounts for changes in body proportions with age.
- Different percentages for head, trunk, and extremities at various ages.
Memory trick: Lund-Browder: Child's Head Big, Legs Small