Abstract：
The percent total body surface area burned is a critical determinant of the required level of care, initial management, and prognosis in burn patients. The current gold standard for estimating this measurement, the Lund-Browder chart, requires familiarity with its construction and may not be practical for use by first responders in the field. In this study, we present a novel burn surface area calculator mobile application developed for first responders and validate its accuracy. Infant, pediatric, and adult manikins were fabricated with eight simulated burns of varying sizes and distributions. 42 pre-clinical medical students and firefighters were tasked with estimating the total body surface area of each burn using both the FireSync-EMS app and Lund-Browder chart. Univariate analysis and mixed-effects linear regression modeling were performed to compare the accuracy of both methods in relation to user experience, manikin size, and burn size. FireSync-EMS significantly reduced overestimation bias (0.11%, SD 2.33 versus 0.91%, SD 4.12, p = 0.002), particularly for burns on child-size manikins (p < 0.001) and burns involving <10% (p = 0.005) and >20% (p = 0.030) total body surface area. Multivariable modeling revealed that the Lund-Browder chart was an independent determinant of the magnitude of estimation error, with a 1.19 times multiplicative effect relative to FireSyncEMS (p < 0.001). Participants overwhelmingly found FireSync-EMS easier, more intuitive, faster, and preferable (p < 0.001 for all). FireSync-EMS may be an easier, faster, and more accurate alternative to the Lund-Browder chart for estimation of the total body surface area burned.
摘要：
烧伤的总身体表面积百分比是所需护理水平的关键决定因素，初始管理，烧伤患者的预后。目前估计这种测量的黄金标准，Lund-Browder图表,需要熟悉其构造，并且可能不适合该领域的急救人员使用。在这项研究中,我们提出了一个新的烧伤表面积计算器移动应用程序开发的第一反应，并验证其准确性。婴儿,儿科,和成年人体模型是用八种大小和分布不同的模拟烧伤制成的。42名临床前医学生和消防员的任务是使用FireSync-EMS应用程序和Lund-Browder图表估算每次烧伤的总表面积。进行了单变量分析和混合效应线性回归建模，以比较两种方法在用户体验方面的准确性。人体模型大小,和燃烧的大小。FireSync-EMS显著降低了高估偏差(0.11%，SD2.33对0.91%，SD4.12,p=0.002),特别是儿童大小的人体模型烧伤（p<0.001）和烧伤涉及<10％（p=0.005）和>20％（p=0.030）的全身表面积。多变量建模表明，Lund-Browder图是估计误差大小的独立决定因素，相对于FireSyncEMS具有1.19倍的乘法效果（p<0.001）。参与者压倒性地发现FireSync-EMS更容易，更直观，更快,并且是优选的（所有p<0.001）。FireSync-EMS可能更容易，更快,更准确的替代Lund-Browder图，用于估算烧伤的总表面积。
