1. What is the Rule of Nines?

Definition: The Rule of Nines is a method used to estimate the total body surface area (TBSA) affected by burns.

Purpose: It helps medical professionals quickly assess burn severity and determine appropriate treatment.

2. How Does the Rule of Nines Work?

The body is divided into regions that represent 9% or multiples of 9% of the total body surface area:

Body Regions:

• Head and neck: 9%
• Each arm: 9% (front and back)
• Each leg: 18% (front and back)
• Front torso: 18%
• Back torso: 18%
• Genitals: 1%

3. Importance of Burn Calculation

Clinical Significance: Accurate TBSA estimation is crucial for:

• Determining fluid resuscitation needs
• Assessing burn severity
• Planning for potential hospitalization
• Predicting patient outcomes

4. Using the Calculator

Instructions: Enter the percentage burned for each body region. The calculator sums these values to give total %TBSA burned.

Note: For pediatric patients, different percentages apply as children have proportionally larger heads and smaller legs.

5. Frequently Asked Questions (FAQ)

Q1: What constitutes a major burn?
A: Typically burns covering >20% TBSA in adults or >10% in children, or burns involving face, hands, feet, or genitals.

Q2: How does this differ for children?
A: Children have larger heads (up to 18%) and smaller legs (about 14% each). Special pediatric charts should be used.

Q3: What about partial thickness vs full thickness burns?
A: The Rule of Nines calculates area only. Depth must be assessed separately for complete evaluation.

Q4: When is the Rule of Nines not accurate?
A: For scattered burns or very small burns. In these cases, the "palm method" (patient's palm = ~1% TBSA) may be better.

Q5: Why is the Rule of Nines important for fluid resuscitation?
A: The Parkland formula (4ml x %TBSA x kg) uses the %TBSA to calculate fluid needs for the first 24 hours.