How is the Rule of Nines used in burn assessment. What are the key components of the Rule of Nines chart. Why is accurate TBSA calculation crucial in burn management. How do smartphone apps enhance burn assessment accuracy.

Understanding the Rule of Nines in Burn Assessment

The Rule of Nines is a crucial tool in burn assessment, providing a quick and efficient method for estimating the total body surface area (TBSA) affected by burns. This system divides the adult body into sections, each representing 9% or a multiple of 9% of the total body surface area.

Here’s a breakdown of the Rule of Nines for adults:

• Head and neck: 9%
• Each arm: 9%
• Chest: 18%
• Back: 18%
• Each leg: 18%
• Groin area: 1%

Why is the Rule of Nines important in burn management? It allows healthcare providers to rapidly assess the severity of burns and make critical decisions regarding treatment and potential transfer to specialized burn centers.

TBSA Assessment: A Critical Factor in Burn Management

Total body surface area (TBSA) assessment is a cornerstone of burn management. It involves calculating the percentage of the body affected by second-degree (partial thickness) burns or higher. This calculation serves several crucial purposes:

1. Determining burn severity
2. Guiding fluid resuscitation
3. Informing decisions about transfer to specialized burn units
4. Communicating the extent of injuries to other healthcare providers

How does TBSA assessment impact fluid resuscitation? The Parkland formula, widely used in burn management, relies on TBSA to calculate fluid requirements:

4 ml/kg Lactated Ringer’s (LR) per %TBSA burn, with half given in the first 8 hours and the remainder over the next 16 hours.

Traditional Methods vs. Modern Technology in Burn Assessment

While traditional methods like the Rule of Nines and Lund-Browder diagrams have been staples in burn assessment for decades, the advent of smartphone technology has revolutionized this process. How do these approaches compare?

Traditional Methods:

• Rule of Nines
• Rule of Palms (1% TBSA = patient’s palm size)
• Lund-Browder diagrams

Modern Technology:

• Smartphone apps for burn assessment
• 3D modeling software
• Automated TBSA calculators

How do smartphone apps enhance burn assessment accuracy? These applications can provide more precise TBSA calculations, automate fluid resuscitation formulas, and offer visual aids for burn mapping. This technology not only improves accuracy but also saves valuable time in emergency situations.

Exploring Burn Assessment Apps: A Review of Top Contenders

The emergence of smartphone apps has significantly impacted burn assessment and management. Let’s examine some of the leading applications in this field:

BurnCase 3D

BurnCase 3D stands out with its impressive 3D modeling capabilities. How does it work? Users can manipulate a 3D human model, marking burn areas with different degrees of severity using fingertip controls. The app offers multiple human models and provides detailed TBSA calculations based on the input.

UMC Burn App

Developed by the University Medical Center Groningen, this app focuses on practical burn management. What features does it offer? The UMC Burn App includes TBSA calculation tools, fluid resuscitation formulas, and guidelines for burn care, making it a comprehensive resource for healthcare providers.

LiAo Burns

LiAo Burns combines simplicity with functionality. How does it assist in burn assessment? The app allows users to quickly mark burn areas on a 2D body diagram, automatically calculating TBSA and providing fluid resuscitation recommendations based on the Parkland formula.

The Impact of Technology on Burn Management

The integration of technology into burn assessment and management has far-reaching implications for patient care. How has this technological shift affected burn treatment?

• Increased accuracy in TBSA calculations
• Faster decision-making in emergency situations
• Improved communication between healthcare providers
• Enhanced documentation and tracking of burn injuries
• More precise fluid resuscitation protocols

These advancements have the potential to improve patient outcomes by ensuring more accurate assessments and timely interventions. However, it’s crucial to remember that technology should complement, not replace, clinical judgment and expertise.

Challenges and Limitations in Burn Assessment

Despite technological advancements, burn assessment still faces several challenges. What are some of the limitations in current burn assessment methods?

• Variability in individual body proportions
• Difficulty in assessing irregularly shaped burns
• Potential for user error in app-based assessments
• Limited accessibility to technology in some healthcare settings
• Need for ongoing training and familiarization with new tools

How can these challenges be addressed? A multifaceted approach combining technology with traditional methods and ongoing education for healthcare providers may offer the most comprehensive solution.

Future Directions in Burn Assessment and Management

The field of burn assessment and management continues to evolve. What emerging technologies and approaches are shaping the future of burn care?

Artificial Intelligence in Burn Assessment

AI algorithms are being developed to analyze burn images and provide automated TBSA calculations. How might this impact burn care? AI-assisted assessment could potentially reduce human error and provide more consistent evaluations across different healthcare settings.

Telemedicine in Burn Management

Telemedicine platforms are enabling remote burn consultations and follow-ups. What benefits does this offer? It can provide specialized burn care expertise to remote or underserved areas, improving access to quality burn management.

Advanced Imaging Technologies

3D scanning and thermal imaging technologies are being explored for more precise burn depth and area assessments. How could these technologies enhance burn care? They may offer more accurate TBSA calculations and better differentiation between burn depths, leading to more tailored treatment plans.

As we look to the future, the integration of these advanced technologies with established clinical practices promises to further improve the accuracy, efficiency, and accessibility of burn assessment and management.

Best Practices in Burn Assessment and Management

While technology continues to advance, certain best practices remain crucial in burn assessment and management. What are some key principles to follow?

1. Prioritize patient safety and comfort during assessment
2. Use a combination of visual inspection and palpation for burn depth evaluation
3. Consider the patient’s age, body habitus, and pre-existing conditions when assessing burns
4. Regularly reassess burns, as their appearance can change over time
5. Maintain clear and thorough documentation of burn assessments
6. Collaborate with burn specialists when dealing with complex or extensive burns
7. Stay updated on the latest guidelines and technologies in burn care

How can healthcare providers ensure they’re following best practices? Regular training, participation in burn care conferences, and staying current with peer-reviewed literature are essential for maintaining expertise in this rapidly evolving field.

The Role of Interdisciplinary Care in Burn Management

Effective burn management often requires a team approach. What specialties are typically involved in comprehensive burn care?

• Emergency Medicine
• Plastic Surgery
• Critical Care
• Anesthesiology
• Physical and Occupational Therapy
• Nutrition
• Psychology
• Nursing

Why is an interdisciplinary approach crucial in burn management? Burns can affect multiple body systems and have long-term physical and psychological impacts. A team approach ensures that all aspects of patient care are addressed, from acute management to long-term rehabilitation and psychological support.

Coordinating Care in Burn Management

How can healthcare systems ensure effective coordination among different specialties? Implementing regular multidisciplinary rounds, utilizing shared electronic health records, and establishing clear communication protocols can enhance collaboration and improve patient outcomes.

The complexity of burn injuries necessitates a holistic approach to care. By combining specialized expertise from various disciplines, healthcare providers can offer comprehensive treatment that addresses not only the physical aspects of burns but also the psychological and social impacts on patients and their families.

Patient Education and Support in Burn Recovery

Beyond the initial assessment and management, patient education plays a crucial role in burn recovery. What key information should be provided to burn patients and their families?

• Wound care instructions
• Pain management strategies
• Nutritional guidance for optimal healing
• Physical therapy and rehabilitation information
• Psychological support resources
• Scar management techniques
• Long-term follow-up schedules

How can healthcare providers ensure effective patient education? Utilizing a combination of verbal instructions, written materials, and digital resources can help reinforce important information. Additionally, involving family members or caregivers in education sessions can improve adherence to care plans and support the patient’s recovery journey.

Support Groups and Resources

Support groups and community resources can play a vital role in burn recovery. How do these resources benefit patients? They provide emotional support, practical advice, and a sense of community for individuals coping with the physical and psychological impacts of burn injuries.

By emphasizing patient education and providing comprehensive support, healthcare providers can empower burn survivors and their families to actively participate in the recovery process, potentially improving long-term outcomes and quality of life.

TBSA Assessment & Burn Apps – Closing the Gap

Hand in hand with determining the depth of a burn wound, determining the total body surface area (henceforth TBSA) involved is critical in describing an injury, determining its severity, and is a key factor in determining immediate treatment and disposition.  In this post, we’ll discuss how to rapidly determine TBSA (in the era of the smartphone and apps).

Clinical Case

A 30-year-old male is brought in by ambulance to the ED with multiple burn wounds.  He states he was extracting essential plant oils in his basement when an explosion occurred.  Flash burns occurred to his chest, arm, scalp, and face, as pictured. Additionally, he had non-circumferential burns of both of his legs (not pictured).  He opted to stay home and clean his basement before seeking help.  Thus, he presents four hours after his injury occurred.

A patient with multiple superficial and partial thickness burns.

You determine that most of the burn wounds are partial thickness (second degree).

Clinical question for consideration:

How extensive is the surface area of this wound, and how do you use that information to guide fluid resuscitation and transfer considerations?

Burn Total Body Surface Area Assessment (TBSA) 

In burn wound TBSA calculation, any wound that is graded as second degree (partial thickness, whether superficial or deep) or greater is included in TBSA assessment.  This percentage burn is then used to describe the severity of the wound to consultants, calculate fluid resuscitation requirements, and determine if transfer for inpatient management at a specialty center is warranted.

Traditional systems for burn TBSA assessment.

Were I writing this post 10 years ago, I would spend more time talking about wound size estimation using the rule of nines, the rule of palms, or Lund-Browder diagrams. Suffice it to say that in austere situations, it pays to remember the basics of these rules.  For example, the rule of nines dictates that, in adults: each arm and the head are 9% TBSA, respectively; the anterior and posterior trunk are each 18%; each leg is 18%; and the final 1% is the genital region.  A cartoon schematic known as a Lund-Browder diagram allows for more accurate estimation of TBSA adjusted for different age ranges.  For smaller burns, the rule of palms states that the patient’s own palm is 1% of his/her TBSA.

The next step is to take the %TBSA and plug it in to a formula for determining the patient’s 24 hour fluid requirement.  IV fluids are essential in the major burn injury to augment the patient’s cardiac output and compensate for insensible losses.  This in turn increases perfusion to the zone of stasis (benefiting the wounds) and maintains the patient’s hemodynamic stability.  Any one of a number of similar formulas will work (in the absence of definitive evidence that one is the best), but the most widely used and generally accepted is the formula from Parkland Memorial Hospital, created by Dr. Charles Baxter and colleagues:

4 ml/kg Lactated Ringer’s (LR) per %TBSA burn

½ over 1^st 8 hrs, ½ over next 16 hrs

So, that’s how it’s done, traditionally: a careful exam followed by a few minutes with a calculator.  But realistically, we live in an age where we carry around little computers in our pockets! Smartphone apps can accurately and rapidly perform these estimations.  Furthermore, many apps can do the math of the Parkland formula (or other resuscitation calculations) to guide resuscitation for you.  While burn apps have been around for a few years, the utility of these applications is starting to receive some backing in the medical literature just this past year.

So, the rest of this post will simply be a review of the best burn-related apps out there.  Disclaimer:  My search was performed using the Apple US App store in December 2014, using the latest OS on an iPhone 5; thus it is very possible that some great apps are missed in this discussion, including on the Android platform.  Please feel free to comment on the post if there is a worthwhile app I have missed!

Burn Apps

Here is a sample of some of the burn-related applications I found in my App store search.  I played with all of the apps mentioned above, and I’d like to discuss in more detail my three favorites.

BurnCase 3D

BurnCase 3D Header Image. The app features use of a 3D model, which can be rotated in space and can have burns of varying degrees drawn on with your fingertip.

BurnCase 3D is an impressive effort by its creators.  This app allows manipulation of a 3D model in space.  The model can be marked with an arrow directed by your fingertip with 1st, 2nd (superficial and partial thickness are separate), 3rd, and 4th degree burns (the final not used in all grading systems, this describes a burn penetrating connective tissue, muscle, and bone).  Several human models are available, including infants & children and adults of “corpulent” builds.  It took a few minutes for me to understand how to use the marker, but once I did, it worked pretty seamlessly.  Once the burns are marked, a calculations page gives exhaustive data including the fluid requirements by Parkland (although not broken down in to hourly rates) and caloric intake requirements.

BurnCase 3D is clearly aimed at burn specialists and those providing care within burn units.  The app allows patient profiles to be saved with identifying information.  Patient photographs of the burns can be added to a file.  All data can be exported via email.  While impressive, these tools are a bit more than the emergency physician needs.  Thus, the bells and whistles actually start to clutter the app, making it a little difficult to use practically in an environment such as the emergency department.  But, the (current) price is right–free! It appears to be in a development phase, after a previous paid version floundered with multiple bugs.

Johns Hopkins BurnMed Lite/Pro

A 3D model can be rotated and space and marked with burn areas.

BurnMed shares some similar features to BurnCase 3D: a 3D model which can be rotated in space, and marked with burned skin areas. This app does not allow separate marking of 1st/2nd/3rd degree burns, but rather makes the assumption that all burns worth marking are 2nd degree or greater.  The use of your finger as a marker made it a little bit difficult to finely demarcate wounds compared with BurnCase 3D, but it is probably sufficient.  The unpaid “lite” version marks the burns, and simultaneously spits out TBSA, but doesn’t allow any further calculation of treatment recommendations without upgrading to the paid version ($4.99).

While I am opposed to paying more than $0.99 for the average app, out of curiosity (and for the benefit of this audience), I bought the upgrade. I was pretty impressed with the features of BurnMed Pro.  After marking the burned areas, “Eight Hour Treatment Guidelines” are provided.  Basic advisement on management is given (administer oxygen, keep the patient warm) followed by IV fluid resuscitation recommendations.  Interestingly, the app will only provide an IV fluid rate if the patient’s TBSA meets the American Burn Association (ABA) recommendations for providing IV fluids (otherwise, it recommends PO hydration). I thought this was a nice touch, as it means that some thought was put in to the algorithm for making treatment recommendations.  Additionally, if any circumferential (or near circumferential) burns are marked, a link is provided to guidelines for when to perform an escharotomy, and an instructional video on the technique. Well done!

Bottom line, it’s a nice app and the target audience seems to be physicians who treat burns relatively infrequently, and could benefit from clear and concise information to guide treatment.  According to the good people at imedicalapps.com (who reviewed this app more formally in 2012), this app was created by Johns Hopkins physicians who were inspired to create an assessment tool after an incident in Kenya where a gas tanker exploded, killing one hundred people and severely burning others.  So, definitely good intentions behind this application.  Still, the price tag is a little high if you don’t treat burn wounds often.

uBurn & uBurn Medic

In uBurn lite, you check off body areas to indicate areas burned.

The final apps I’ll discuss here are uBurn, uBurn lite and uBurn Medic.  The same company, JAMB Innovations, produces these tools.

Rather than the detailed demarcation of burns that you perform with BurnCase 3D and BurnMed, in uBurn lite you just check off the burned areas with your finger’s touch, and a check mark appears.  It’s similar to a Lund-Browder diagram, but interactive.  In the paid uBurn program, you also have the option to look at body parts in detail, adjust a slider to set the percentage burned, and then bring this TBSA data to a separate calculation screen.  You then plug in a weight for the patient and it provides you with: the fluid requirement in the first 8 hours, the first 24 hours, and the expected urine output for the patient’s weight.  There is an option to factor in time since injury and fluid given prior to arrival, which is nice for real world application (also a feature of BurnMed, but less obvious to locate within the app).

Additional features include teaching tools for differentiating different burn depths, and an explanation of the rule of nines.  There is also a child model available (which is actually an infant). The app is much simpler than the aforementioned BurnCase 3D and BurnMed, which in many ways I actually prefer.  A tool like this is probably adequate for the average trained emergency physician, and the price is reasonable at $1.99. (The lite version is free, and is probably also sufficient).

Among the apps I’ve discussed, uBurn has the distinction of being validated in a randomized, blinded study as a tool for fluid calculation in burn resuscitation (versus a person with a calculator and another burn app not available in the US app store).

Adult burn calculation in uBurn Medic. Fluid resuscitation rates result on the same screen, with no additional clicks or swipes. Pediatric counterpart for uBurn Medic. Only infant and adult “models” are available, though patient age can be manually entered.

Along that vein, in some ways I liked uBurn Medic even more.  As suggested by the name, this app is actually more geared towards pre-hospital care, and gives direction to the pre-hospital provider.  After you check off the burned body areas, the app will instantly calculate an initial IV fluid rate further broken down in to an IV fluid hourly rate (further broken down in to a per minute, per 15 second, and per 10 second gtt). There is a clock icon which allows you to enter the time since the burn, which then recalculates the IV fluid rate to play “catch up” for the late presenting burn.  There is a toggle between thermal and electrical burns (the latter which doubles the fluid requirement).  The most beautiful part is that it’s all on one screen, with fewer clicks and distractions than the other apps.  It’s a little more quick-and-dirty than the other apps, but what it does, it does pretty well.

From a technical standpoint, I did notice that both of these apps by JAMB seemed to freeze up and crash if I attempted to adjust data values too frequently/rapidly. Occasionally I had to close and restart the app to get it working again.  I found this to be a reproducible problem on multiple uses; granted, I was changing parameters pretty frequently and pushing the app to its limit.

I imagine this app is perfect in the pre-hospital setting, but I think it would work pretty well for the emergency physician as well, who is simply trying to rapidly estimate a fluid resuscitation rate.  It is not a thoughtful app, like BurnMed: it will give you an IV fluid rate for a 1% TBSA burn, and doesn’t advise you when escharotomies may be indicated.  But, if you have a good grasp on basic principles of burn care and are simply looking for a rapid Parkland formula calculation, this may be the right choice.  uBurn Medic is also priced at $1.99.

Case Resolution

This patient has several patchy areas of superficial and deep partial thickness burns.  Hoping to visually reproduce his burn injuries, you use BurnMed to create a schematic representation of his burn distribution:

You calculate 20.2% TBSA.

The app directs you to give IV fluid solution at 400 ml per hour for 7 hours.  However, the patient was already given 1 liter of normal saline IV during EMS transport, and his burn occurred 4 hours ago, which affects calculations.  You thus enter this additional data, and calculate an initial bolus of 600 ml, followed by a rate of 400 ml for the next 4 hours.

You are curious what the fluid rate will be beyond the initial 8 hour period, as you plan to transfer this patient to a burn center and anticipate a prolonged hospital course.  As BurnMed does not perform this computation, you switch to UBurn and enter the same data.

You are then able to quickly order the fluid rate beyond the initial 8 hour period.

You initiate a transfer, and the Burn Surgeon at the accepting facility requests a visual schematic of the burn area.  He is familiar with BurnCase 3D, which he uses to manage his patients on his ward.  You reproduce your schematic using this app, then email him a copy of the data using the “Export” function.

The menu page for the app describes its current functions, including the ability to export data via email.

 Summary & Conclusions

As in many specialized fields in medicine, the nature of burn care is evolving–not so much in the basic principles of management, but rather, in the technology used to provide this care.  Burn apps are rapidly gaining acceptance as a tool for assisting in the emergency management of the burn victim.

In the next part in this series, we’ll delve in to wound management for the minor burn injury that you would “treat & street” from an ED or office environment.

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Coding for Burns – AAPC Knowledge Center

Approximately every minute, someone in the United States sustains a burn injury serious enough to require treatment. According to the American Burn Association, an estimated 486,000 hospital admissions and visits to hospital emergency departments occur annually for burn evaluation and treatment in the United States. The likelihood for a medical coder to have to code a burn case is extremely high. Here’s what you need to know.

Burn Types

A burn is tissue damage with partial or complete destruction of the skin caused by heat, chemicals, electricity, sunlight, or nuclear radiation. Proper selection of burn codes requires consideration of the location of the burn, severity, extent, and external cause in addition to laterality and encounter. ICD-10 makes a distinction between burns and corrosions:

• Burn codes apply to thermal burns (except sunburns) that come from a heat source, such as fire, hot appliance, electricity, and radiation.
• Corrosions are burns due to chemicals.

Degrees of Burns

Burn severity is classified based on the depth of the burn. There are six degrees of burns:

• First-degree burns damage the outer layer (epidermis) of the skin; erythema
• Second-degree burns indicate blistering with damage extending beyond the epidermis partially into the layer beneath it (dermis)
• Third-degree burns indicate full-thickness tissue loss with damage or complete destruction of both layers of skin (including hair follicles, oil glands, & sweat glands)

ICD-10 Coding Using the “Rules of Nines”

You need at least three codes to properly report burn diagnoses:

First-listed code(s): S/S for site and severity (categories T20-T25)

• Your first-listed code will be a combination code that reports both the site and severity of the injury. The descriptions of codes in the T20-T28 range are first defined by an anatomical location of the body affected by burn or corrosion.
• The fourth character for each category identifies the severity (except categories T26-T28). Using the layers of the skin, the severity of a burn is identified by degree.
• The fifth character reports additional details regarding the anatomical site of the burn.
• The sixth character represents laterality.

Next listed code: E for extent (categories T31/32)

• Burns and corrosions are classified according to the extent, or percentage, of the total body surface area involved (TBSA).
• Code T31 to report a burn and T32 to report corrosion, based on the classic “rule of nines.”
  • The rule of nines, for adult patients, assigns 1% of TBSA to the genitalia, and multiples of 9% to other body areas (9% head, 9% per arm, 18% per leg, etc.).
  • A modified rule of nines is applied for infants, to account for their relatively larger head (18%) and smaller legs (14%, each).
• The required fourth character identifies the percentage of the patient’s entire body affected by burns. The fifth character identifies the percentage of the patient’s body that is suffering from third-degree burns or corrosions only.

Lastly, code(s): E for external cause code(s)

• External Cause – To identify the source, place, and intent of the burn.
• Agent – To identify the chemical substance of the corrosion.

ICD-10-CM guidelines recommend reporting appropriate external cause codes for burn patients. Not all payers accept these codes, however.

CPT Coding Using the Lund-Browder Classification

CPT codes to report local treatment of burns and many skin grafting procedure codes, specify the surface area (TBSA) treated. CPT® utilizes the more precise Lund-Browder classification method to calculate TBSA for burns and grafts. Lund-Browder divides the body into 19 distinct areas and specifies six different age groups to account for the changes in body composition during development into adulthood.
The CPT® code book contains a Lund-Browder classification method chart for easy TBSA calculation by body area and patient age.

• Author
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Stacy Chaplain

Stacy Chaplain, MD, CPC, is a development editor at AAPC. She has worked in medicine for more than 23 years, with an emphasis on education, writing, and editing since 2015. Chaplain received her Bachelor of Arts in biology from the University of Texas at Austin and her doctorate in medicine from the University of Texas Medical Branch in Galveston. She is a member of the Beaverton, Ore., local chapter.

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9 Rules for constructing diagrams

Normative documentation base: www.complexdoc.ru

This situation is explained in more detail in Figure 24.

Figure 24

When constructing diagrams, the following rules must be observed.

1 The model must contain an A-0 context diagram that contains only one block. The number of the single box on the A-0 context diagram should be

0.

2 The boxes on the diagram should be placed diagonally from the upper left to the lower right corner of the diagram, in the order of the assigned numbers. Blocks in the diagram, located at the top left, “dominate” the blocks located

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bottom right. “Dominance” is understood as the influence that a block has on other diagram blocks. The arrangement of the blocks on the diagram sheet reflects the author’s understanding of dominance. Thus, the topology of the diagram shows which features have a greater impact on the others. When the blocks operate in parallel, the dominance relation is often formal, and the diagonal arrangement of the blocks only contributes to the readability of the diagram.

3 Diagrams (except diagram A-0) must contain at least three and not more than six blocks. These constraints keep the complexity of the diagrams at a level that is readable, understandable, and usable.

Diagrams with less than three blocks raise serious doubts about the need for decomposition of the parent function. Diagrams with more than six blocks are difficult for readers to understand and make it difficult for the author to enter all the necessary graphic objects and labels into it.

4 Each block of a non-context diagram is assigned a number placed in the lower right corner; the numbering order is from the top left to the bottom right block (from 1 to 6).

5 Each block subjected to decomposition must have a link to a child diagram; a link (for example, a node number, C-number, or page number) is placed under the lower right corner of the block.

6 Block names (executable functions) and arrow labels must be unique. If the arrow labels are the same, it means that the arrows display the same data.

7 If there are arrows with a complex topology, it is advisable to repeat the label for ease of identification.

8 Provide maximum distance between blocks and arrow turns, and between blocks and arrow intersections to facilitate reading of the diagram. At the same time, the probability that two different arrows will be mixed up is reduced.

9 Blocks must always have at least one control and one input arrow, but may not have output arrows.

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10 If the same data is used for both control and entry, only the control arrow is drawn. This emphasizes the control nature of the data and reduces the complexity of the chart.

11 The maximum distance between parallel arrows makes it easier to place marks, read them and trace the paths of the arrows (figure 25).

Figure 25

12 Arrows are linked (merge) if they represent similar data and their source is not indicated in the diagram (Figure

26).

Figure 26

13 Control feedback should be shown as “up and over” (Figure 27a).

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Figure 27

Input feedback should be shown as “down and under” (Figure 27b). Feedback is also shown through the mechanism (Figure 27c). This ensures that feedback is shown with a minimum number of lines and intersections.

14 Cyclic feedbacks for the same block are displayed only to highlight them. Typically, feedback is shown on a diagram that decomposes a block. However, sometimes you need to highlight reusable objects (Figure 28).

Figure 28

15 Arrows are merged if they have a common source or destination, or if they represent related data. A common name better describes the essence of the data. The number of arrows touching each side of the block should be minimized, unless, of course, the nature of the data is too heterogeneous (Figure 29).).

Figure 29

16 If possible, the arrows are attached to the blocks in the same position. Then the connection of arrows of a particular type with blocks will be consistent and the reading of the diagram will be simplified (Figure 30).

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Figure 30

17 When connecting a large number of blocks, it is necessary to avoid unnecessary intersections of arrows (Figure 31). The number of loops and turns of each arrow should be minimized (Figure 32).

Figure 31

Figure 32

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data, without specifically defining how individual pieces of data relate to any block (Figure 33).

Figure 33

19 The type of interface shown in Figure 34 is preferred as it defines specific data related to each block.

Figure 34

20 It is necessary to use (where appropriate) the expressive possibilities of branching arrows (Figure 35).

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Diagram guide. Part 2. Basic rules for their design in presentations and reports – Design on vc.ru

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Charts – one of the most difficult elements to design along with tables and large diagrams. Authors of documents often do not know how to properly format them, so charts look overloaded with data and are difficult to read.

How to make the process of designing a diagram easy? You need to know a few basic rules and follow the algorithm that we have given in this article.

This article is the second part of the chart guide. In the first part, we explained why charts often make data difficult to read and how to choose the right chart type for your information.

Here we provide answers to such questions

• how to save diagrams from visual “overload”?
• how to simplify the perception of diagrams?
• how to style a diagram to make it look pretty?

In this article, you will see several case studies of our chart design agency.

Unattractive diagrams: visual overload

In the first part of the guide, we wrote that a lot of unnecessary elements in a diagram and a colorful color palette are one of the basic problems of diagrams. If you describe these problems in more detail, then you can see the main 4 errors in them:

• Error 1: there are extra elements in the diagram that do not perform any task, but draw the attention of the viewer,
• Error 2: the viewer has to move their eyes around the chart area to match the labels and colors; it takes time,
• Error 3: Presentation palette contains colors that don’t match,
• Error 4: Chart title does not help you understand what idea to extract from the chart.

Below we analyze these errors in the three most popular types of charts: pie chart, histogram and graph.

How to draw a pie chart

Look at the pie chart below. It consists of the following elements:

• chart title,
• sector diagram,
• data labels – labels near sectors with a numerical display of the sector size,
• legend — sector color designation and element name.

This chart has 3 of the 4 errors we described: the legend makes the viewer look around the area of ​​the chart and compare colors, the palette consists of bright incongruous shades, the title does not communicate the idea.

To improve the chart, let’s fix these errors:

• Step 1. Get rid of the legend: add text boxes with element names next to the sectors.
• Step 2. Recolor the sectors with colors from the presentation palette. If the diagram has a main sector, then we focus on it with the help of color: this sector should be the most contrasting. The remaining sectors can be painted in dimmer shades of the same color.
• Step 3. Let’s formulate the idea of ​​the diagram and place it in the title.

If there is a main sector in the diagram with which the idea is connected, then we will get the diagram on the left. If there is no main sector, then the diagram is on the right.

A few more tips on how to design pie charts:

• if the chart has more than 6 sectors, then combine the small sectors into “other” or “other”,
• if there is a main sector in the diagram, then it should start in the same place, the number “12” on the dial (imagine that the pie chart is a dial). So done in the diagram on the left,
• The main sector of the chart can be moved out of the center to make it more visible. But pushing all sectors of the chart out of the center is a mistake.

How to style bar and bar charts

A histogram, or bar chart, usually consists of more elements. The bar (horizontal) chart is similar in structure, so we will not analyze it separately.

In general, a histogram and a column chart are different types of charts. A histogram visualizes the distribution of data, while a bar chart shows how one variable changes over time. But since both Jim Zelazny’s popular book Speak Chart Language and MS Office use the word “histogram” for both distribution and for showing the dynamics of values ​​over time, in this guide we also use the concept of “histogram” in both cases.

This diagram contains all 4 errors. Let’s get rid of them:

• Step 1. Remove unnecessary elements: legend, vertical axis and grid lines.

There is a reason why the vertical axis and grid are not needed in such a histogram. When columns have data labels, the viewer reads the size of the column from them, and the vertical axis is not needed. Therefore, grid lines are not needed, which allow you to determine the height of the column along the vertical axis.

• Step 2. Make sure that all the information the viewer needs is next to the columns: these are time points and data labels.
• Step 3. Use the colors from the brand book.
• Step 4. Write down the idea of ​​the diagram in the title.

Here is the histogram and bar chart we got:

For these types of charts, the main thing is to get rid of unnecessary elements that do not perform any function: usually these are vertical (for a bar chart) and horizontal (for a bar chart) axes and grid lines. But be sure to add data labels so that the viewer can quickly see the size of the column.

If the diagram has a main column, then it can be highlighted brightly, as in the diagram on the right.

How to draw up a schedule

How a bar chart differs from a graph, we wrote in a previous article (insert link). In short: with a large number of time points, it is worth choosing a chart.

3 graphs are plotted in the same area at once. As in the previous example, we see all 4 errors: there are extra elements that do not perform any task (for example, the vertical axis), the colors of the graphs do not match, you have to look from values ​​to the legend. And, of course, the title does not help to understand the main idea.

Let’s fix this:

• Step 1. Get rid of the vertical axis and grid lines.
• Step 2. Replace the legend with captions next to the graphs.
• Step 3. Let’s replace the base colors of the diagram with the colors from our palette.
• Step 4. Let’s formulate the idea and write it in the title.

Note that we have left the projection lines. These are the vertical lines that run from the data points to the horizontal axis. They help the viewer to determine what point in time the value is associated with, and you should not get rid of them.

We do not recommend using multiple markers (circles, squares, triangles, etc.) on the same chart. In our example, the markers are round, but thanks to the colors, the viewer does not confuse the graphics with each other.

Note that we also recommend coloring the data labels with the colors of the graphs. And sometimes the data labels have to be moved manually so that they do not overlap each other and do not go into the lines.

How to design charts with different variables

Sometimes you need to show several variables at once in one diagram. If they are close in meaning and are measured in the same units (for example, revenue and profit), one type of chart can be used for this.

But if you need to plot several different variables on the diagram (for example, revenue and marginality), then you should use a histogram for one variable, and a graph for the other.

MOVmedia is your partner for data visualization

Data visualization is a whole discipline that you need to dive into if you want to visualize ideas well. We have a lot of case studies on similar tasks in our portfolio – let’s look at some of them.

Minimalistic diagrams allow you to quickly capture the essence and convince the viewer to make the decision you need.

Data visualization can be approached more creatively: for example, here the icons in the form of a person replace the bar chart.

A slide can contain several charts at the same time. In this case, it is important that they are visually combined with each other.

Reporting presentations often feature slides rich in diagrams. To get all the charts you want on a slide, you need to spend time working with the slide composition.

Conclusion from the chart guide

Working with charts is not only about the design and the choice of colors.