ortho-trauma emergency

Rule of Nines — Burns Body Surface Area

Estimates total body surface area (TBSA) burned using the Wallace Rule of Nines (adult proportions). In children use a Lund and Browder chart — head and limb proportions change with age. Used to guide fluid resuscitation (Parkland formula), admission and burn-centre referral.

Used in: Burns

Score interpretation

Minor Burns (<10% TBSA) 0–9

Burns <10% TBSA — minor burn injury

→ Wound care; analgesia; consider outpatient management if <5% TBSA, superficial partial thickness, no special areas; return precautions given; follow-up in 24–48h

Moderate Burns (10–25% TBSA) 10–24

Burns 10–25% TBSA — moderate burn injury

→ Hospital admission; IV access; Parkland fluid resuscitation; IV analgesia; wound assessment; early burns team involvement; nutrition planning; monitor urine output (target 0.5–1 mL/kg/hr)

Major Burns (>25% TBSA) 25–100

Burns >25% TBSA — major burn injury

→ Burns centre transfer; aggressive IV resuscitation (Parkland formula); airway management — early intubation if facial/airway burns; IV opioid analgesia; temperature management; early escharotomy if circumferential; multidisciplinary burns team; family communication

Interpretation bands for the Rule of Nines. Apply clinical judgement and local guidance.

References

Wallace AB. The exposure treatment of burns. Lancet. 1951;1(6653):501–504.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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