ToolsCalculators
Rule of Nines for Burn Surface Area
Estimates total body surface area burned in adults.
Rule of Nines for Burn Surface Area
Head and neck (9%)
Right arm - entire (9%)
Left arm - entire (9%)
Anterior trunk (18%)
Posterior trunk (18%)
Right leg - entire (18%)
Left leg - entire (18%)
Perineum / genitalia (1%)
Result0 % TBSA
Estimated total body surface area burned. Adults with >=15-20% TBSA usually need formal fluid resuscitation and burn-centre referral.
- Total body surface area
- 0 %
When to use
- Rapid bedside estimate of adult burn size to guide fluid resuscitation and transfer.
- Count only partial- and full-thickness (second- and third-degree) burns.
Formula
Adult regional percentages: head/neck 9, each arm 9, anterior trunk 18, posterior trunk 18, each leg 18, perineum 1. Sum the involved regions (use partial fractions for incomplete regions).
Pearls and pitfalls
- The adult scheme overestimates in young children, whose heads are relatively larger - use a paediatric (Lund-Browder) chart instead.
- The patient's palm (including fingers) approximates 1% TBSA for scattered burns.