1. What is the Rule of Nines?

The Rule of Nines is a method used to estimate the total body surface area (TBSA) affected by burns. It divides the body into sections that represent 9% or multiples of 9% of the total body surface, making it easy to calculate burn extent quickly in emergency situations.

2. How Does the Calculator Work?

The calculator uses the standard Rule of Nines percentages:

Where:

• Head — 9% of TBSA
• Each Arm — 9% of TBSA
• Each Leg — 18% of TBSA
• Front Torso — 18% of TBSA
• Back Torso — 18% of TBSA
• Genitals — 1% of TBSA

Explanation: The percentages add up to 100% of the body surface area. For partial burns, clinicians often estimate the percentage of each affected region that is burned.

3. Importance of TBSA Calculation

Details: Accurate TBSA estimation is crucial for determining fluid resuscitation needs, prognosis, and treatment decisions in burn patients. Burns exceeding 20% TBSA in adults often require specialized burn care.

4. Using the Calculator

Tips: Check all body regions that are affected by burns. For partial burns of a region, clinicians typically estimate the percentage of that region affected (e.g., half of the back = 9%).

5. Frequently Asked Questions (FAQ)

Q1: How does this differ for children?
A: Children have proportionally larger heads and smaller legs, so modified percentages are used (e.g., head is 18% in infants).

Q2: What about burns to the palms?
A: The patient's palm (not including fingers) represents about 1% of TBSA and can be used for small burns.

Q3: When is the Rule of Nines not accurate?
A: In obese patients, pregnant women, or those with unusual body proportions, the rule may over- or under-estimate TBSA.

Q4: What's considered a major burn?
A: Typically burns >20% TBSA in adults, >10% in children, or burns involving face, hands, feet, or genitals.

Q5: How does this relate to fluid resuscitation?
A: The Parkland formula uses TBSA to calculate fluid needs (4ml × %TBSA × kg body weight in first 24 hours).