1. What is the Rule of Nines for Burn Assessment?

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

Purpose: It helps medical professionals quickly assess burn severity and determine appropriate treatment, including fluid resuscitation needs.

2. How Does the Rule of Nines Work?

The body is divided into regions that represent approximately 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 TBSA Calculation

Clinical Significance: Burn severity is classified by TBSA affected. Major burns (>20% TBSA in adults) require specialized care and fluid resuscitation based on the Parkland formula.

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 partial burns to a region, estimate the percentage of that specific region affected (e.g., if half the front torso is burned, enter 9%).

5. Frequently Asked Questions (FAQ)

Q1: Is the Rule of Nines different for children?
A: Yes, children have proportionally larger heads and smaller legs. Pediatric modifications adjust these percentages.

Q2: What about burns to the palm?
A: The patient's palm (not including fingers) represents about 0.5% TBSA and can be used for small burns.

Q3: When is the Rule of Nines not accurate?
A: For obese or very muscular patients, or when burns are scattered across multiple regions.

Q4: What's considered a major burn?
A: In adults: >20% TBSA (or >10% in children/elderly), or burns to hands, face, feet, or genitals.

Q5: How does TBSA affect treatment?
A: Fluid resuscitation (Parkland formula: 4ml × %TBSA × kg body weight) and need for burn center referral depend on %TBSA.