Rule of Nines

Estimates Total Body Surface Area (TBSA) of adult burn injuries.

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Parameters

Entire Head and Neck (9%)

Yes, this condition applies to the patient

Chest (Front) (9%)

Yes, this condition applies to the patient

Abdomen (Front) (9%)

Yes, this condition applies to the patient

Upper Back (9%)

Yes, this condition applies to the patient

Lower Back & Buttocks (9%)

Yes, this condition applies to the patient

Entire Left Arm (9%)

Yes, this condition applies to the patient

Entire Right Arm (9%)

Yes, this condition applies to the patient

Left Leg Front (9%)

Yes, this condition applies to the patient

Left Leg Back (9%)

Yes, this condition applies to the patient

Right Leg Front (9%)

Yes, this condition applies to the patient

Right Leg Back (9%)

Yes, this condition applies to the patient

Genitals / Perineum (1%)

Yes, this condition applies to the patient

Rule of Nines Result

FormulaHead (9) + Torso front (18) + Torso back (18) + Arms (9 each) + Legs (18 each) + Genitals (1).

Clinical Pearls

Provides a rapid, standardized method for first responders and ER clinicians to calculate the percentage of skin burned, which directly dictates fluid resuscitation volumes.

Limitations

Only applies to adults. Children have relatively larger heads and smaller legs, requiring the pediatric-specific Lund-Browder chart.

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