HOW BIG IS A HAND

Use of the patient's hand to estimate percentage body surface area (BS A) of injury is well established in the management of bums. Exactly wh at constitutes 'the palm of the hand' and how large an area this is, d epends on whether you follow Advanced Trauma Life Support teaching, Un ited Kingdom teaching, or use a 'Lund and Browder chart'. A study was designed to measure the areas in question to find which was most accur ate. The conclusions challenge standard teaching and show a sex differ ence. The area of the palm alone is 0.5 per cent BSA in males and 0.4 per cent BSA in females, whereas the area of the palm plus the palmar surface of the Foe digits is 0.8 per cent BSA in males and 0.7 per cen t BSA in females. Therefore if a hand alone is used to assess the size of a burn the per cent BSA could be overestimated.