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作为烧伤院前评估工具的连续减半法与九分法的比较。

A comparison of serial halving and the rule of nines as a pre-hospital assessment tool in burns.

作者信息

Smith J J, Malyon A D, Scerri G V, Burge T S

机构信息

Department of Plastic Surgery, The Royal Hospital Haslar, Gosport, Hampshire PO12 2AA, UK.

出版信息

Br J Plast Surg. 2005 Oct;58(7):957-67. doi: 10.1016/j.bjps.2005.04.007.

Abstract

Following endorsement of serial halving by the Faculty of Pre-Hospital Care of the Royal College of Surgeons of Edinburgh this study aimed to determine whether the technique was comparable to the rule of nines in making initial assessments of body surface area burned. Ten 'casualties' were made up to represent burn victims (range 6-61%). An external panel of six consultants and one specialist registrar in plastic surgery were invited to assess the simulated casualties. They gave individual and a consensus estimate of the burned areas. One hundred and twenty-five members of local emergency services and military paramedical staff were given a brief video and slide presentation describing either the rule of nines or serial halving method of burn area assessment. These techniques were then used to assess the 10 simulated casualties, giving 1250 estimates of burn surface area. The understanding of both techniques appeared adequate in both test groups. Estimates from serial halving and rule of nines groups differed from the assessments of the external panel. No statistical difference was demonstrated between serial halving and the rule of nines as an initial assessment tool when determining disposal. Serial halving has an inherent weakness when assessing certain sizes of burn. The rule of nines requires that the assessor knows and understands the proportionate areas of the body. The mathematics of percentages and fractions appeared to confuse some assessors.

摘要

在爱丁堡皇家外科医学院院前护理学院认可连续减半法后,本研究旨在确定该技术在对烧伤体表面积进行初步评估时是否与九分法相当。组建了10名“伤员”来代表烧伤受害者(范围为6%-61%)。邀请了一个由六名整形外科顾问和一名专科住院医生组成的外部小组来评估模拟伤员。他们给出了烧伤面积的个人估计和共识估计。125名当地紧急服务人员和军事医护人员观看了一段简短的视频和幻灯片演示,内容是关于烧伤面积评估的九分法或连续减半法。然后使用这些技术来评估这10名模拟伤员,得出了1250个烧伤表面积估计值。两个测试组对这两种技术的理解似乎都足够。连续减半组和九分法组的估计值与外部小组的评估结果不同。在确定处置方式时,连续减半法作为一种初步评估工具与九分法之间没有显示出统计学差异。在评估某些大小的烧伤时,连续减半法有一个内在的弱点。九分法要求评估者了解并理解身体各部分的比例面积。百分比和分数的数学运算似乎让一些评估者感到困惑。

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