A 1% TBSA Chart Reduces Math Errors While Retaining Acceptable First-Estimate Accuracy.
A 1% TBSA Chart Reduces Math Errors While Retaining Acceptable First-Estimate Accuracy.
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DOI：
10.1093/jbcr/irab192
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发表时间：
2022-05-17
影响因子：
1.4
通讯作者：
Fabia, Renata
中科院分区：
文献类型：
--
作者：
Ray, William C.;Rajab, Adrian;Alexander, Hope;Chmil, Brianna;Rumpf, Robert Wolfgang;Thakkar, Rajan;Viswanathan, Madhubalan;Fabia, Renata
在估计烧伤总体表面积百分比（%TBSA烧伤）时，发生危及生命和改变治疗的错误的频率不可接受。作为回应，已经进行了许多尝试，以改进通常用于估计三丁基锡化合物燃烧百分比的图表。最近的研究表明，三丁基锡化合物燃烧百分比估计数的最大误差可能来自图表中不准确数值以外的来源。在这里，我们对可能的误差来源及其对%TBSA烧伤估计值的影响进行了分类。此外，我们观察到，不同的护理人员有不同的估计需求：第一反应者需要足够准确的快速估计，使他们能够开始护理和确定患者的运输方案，而烧伤外科医生订购皮肤移植的精度要求平方厘米，并可以提供相当长的时间来达到这一精度。这些相互竞争的需求表明，一个工具适合所有照顾者的方法是次优的。因此，我们提出了一个有效的，简化的烧伤图表，最大限度地减少了%TBSA烧伤估计的随机误差的最大来源之一，简单的计算误差，同时也是快速的，需要很少的培训。NCHart-1还可以实现简单的共识估计，以及在护理人员之间分离估计子任务，从而在大规模伤亡情况下实现几个潜在的改进。我们的研究结果表明，NCHart-1具有第一响应者所需的准确性，同时在不到2分钟的时间内可靠地产生结果。在接受调查的76名医疗保健专业人员中，绝大多数人表示更喜欢NCHart-1，而不是他们以前的方法，以便于使用和培训。对于NCHart-1的临床或商业用途，请联系：tech. nationwidechildrens.org
Life-threatening and treatment-altering errors occur in estimates of the percentage of total body surface area burned (%TBSA burned) with unacceptable frequency. In response, numerous attempts have been made to improve the charts commonly used for %TBSA-burned estimation. Recent research shows that the largest errors in %TBSA-burned estimates probably come from sources other than inaccurate values in the charts. Here, we develop a taxonomy of the possible sources of error and their impact on %TBSA-burned estimates. Also, we observe that different caregivers have different estimation needs: First-responders require a rapid estimate with sufficient accuracy to enable them to begin care and determine patient transport options, while burn surgeons ordering skin grafts desire accuracy to the square centimeter, and can afford considerable time to attain that accuracy. These competing needs suggest that a one-tool-fits-all-caregivers approach is suboptimal. We therefore present a validated, simplified burn chart that minimizes one of the largest sources of random errors in %TBSA-burned estimates—simple calculation errors—while also being quick and requiring little training. NCHart-1 also enables simple consensus estimates, as well as separation of estimation subtasks across caregivers, leading to several potential improvements in mass casualty situations. Our results demonstrate that NCHart-1 possesses the accuracy necessary for first responders, while reliably producing results in less than 2 minutes. Of 76 healthcare professionals surveyed, a large majority indicated a preference for NCHart-1 over their previous methods for ease of both use and training. For clinical or commercial use of NCHart-1, please contact: tech.commercialization@nationwidechildrens.org
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DOI：
10.1016/j.burns.2020.07.001
发表时间：
2021-03
期刊：
Burns : journal of the International Society for Burn Injuries
影响因子：
--
作者：
Hughes A;Almeland SK;Leclerc T;Ogura T;Hayashi M;Mills JA;Norton I;Potokar T
通讯作者：
Potokar T
影响因子：
1.4
作者：
McCulloh, Christopher;Nordin, Andrew;Thakkar, Rajan K.
通讯作者：
Thakkar, Rajan K.
DOI：
10.1097/00004630-198609000-00007
发表时间：
1986-09-01
期刊：
The Journal of burn care & rehabilitation
影响因子：
--
作者：
Berkebile, B L;Goldfarb, I W;Slater, H
通讯作者：
Slater, H
影响因子：
1.4
作者：
Benjamin, Nicole C.;Lee, Jong O.;Herndon, David N.
通讯作者：
Herndon, David N.
DOI：
10.1097/00005373-198710000-00011
发表时间：
1987-10-01
影响因子：
--
作者：
HAMMOND, JS;WARD, CG
通讯作者：
WARD, CG