FireSync EMS: A Novel Mobile Application for Burn Surface Area Calculation

The percent total body surface area (TBSA) burned is a critical determinant of the required level of care, initial management, and prognosis in patients with burns. The current gold standard for estimating this measurement, the Lund-Browder (LB) 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 8 simulated burns of varying sizes and distributions. In total, 42 preclinical medical students and firefighters were tasked with estimating the TBSA of each burn using both the FireSync EMS app and LB 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 vs 0.91%, SD 4.12, P = .002), particularly for burns on child-size manikins (P < .001) and burns involving <10% (P = .005) and >20% (P = .030) TBSA. Multivariable modeling revealed that the LB chart was an independent determinant of the magnitude of estimation error, with a 1.19 times multiplicative effect relative to FireSync EMS (P < .001). The participants overwhelmingly found FireSync EMS easier, more intuitive, faster, and preferable (P < .001 for all). FireSync EMS may be an easier, faster, and more accurate alternative to the LB chart for estimation of the TBSA burned.