Estimating body surface area

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Rule of Nines

Rule of Nines
Adults
Anatomic structure Surface area
Anterior Head 4.5%
Posterior Head 4.5%
Anterior Torso 18%
Posterior Torso 18%
Each Anterior Leg 9%
Each Posterior Leg 9%
Each Anterior Arm 4.5%
Each Posterior Arm 4.5%
Genitalia/Perineum 1%
Children
Anatomic structure Surface area
Anterior Head 9%
Posterior Head 9%
Anterior Torso 18%
Posterior Torso 18%
Each Anterior Leg 6.5%
Each Posterior Leg 6.5%
Each Anterior Arm 4.5%
Each Posterior Arm 4.5%
Genitalia/Perineum 1%

Rule of Palms

  • Patient's entire hand (palm+fingers) = about 1% TBSA
  • Use to estimate scatter burns
  • Also use for local burns up to 10% BSA

Lund-Browder Classification

Lund Browder Chart to document initial TBSA assessment.

An alternative method of estimate burn surface area

  • More accurate than "Rule of Nines," especially in pediatric patients
Children
Anatomic structure 0 Yr 1 Yr 5 Yrs 10 Yrs 15 Yrs
Anterior Head 9.5% 8.5% 6.5% 5.5% 4.5%
Posterior Head 9.5% 8.5% 6.5% 5.5% 4.5%
Anterior Neck 1% 1% 1% 1% 1%
Posterior Neck 1% 1% 1% 1% 1%
Anterior Torso 13% 13% 13% 13% 13%
Posterior Torso 13% 13% 13% 13% 13%
Each Anterior Upper Leg 2.75% 3.25% 4% 4.25% 4.5%
Each Posterior Upper Leg 2.75% 3.25% 4% 4.25% 4.5%
Each Anterior Lower Leg 2.5% 2.5% 2.75% 3% 3.25%
Each Posterior Lower Leg 2.5% 2.5% 2.75% 3% 3.25%
Each Anterior Upper Arm 2% 2% 2% 2% 2%
Each Posterior Upper Arm 2% 2% 2% 2% 2%
Each Anterior Lower Arm 1.5% 1.5% 1.5% 1.5% 1.5%
Each Posterior Lower Arm 1.5% 1.5% 1.5% 1.5% 1.5%
Each Anterior Hand 1.5% 1.5% 1.5% 1.5% 1.5%
Each Posterior Hand 1.5% 1.5% 1.5% 1.5% 1.5%
Each Anterior Foot/Ankle 1.75% 1.75% 1.75% 1.75% 1.75%
Each Posterior Foot/Ankle 1.75% 1.75% 1.75% 1.75% 1.75%
Each Buttock 2.5% 2.5% 2.5% 2.5% 2.5%
Genitalia/Perineum 1% 1% 1% 1% 1%

See Also

References

Authors:

Ross Donaldson