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❇️ RULE OF NINES (ADULT)

• The Rule of Nines is a rapid clinical method used to estimate the Total Body Surface Area (TBSA) involved in burns in adults
• It helps in burn severity assessment, fluid resuscitation, triage, and burn center referral

Body Surface Area Distribution (Adults)
• Head and neck → 9%
• Each upper limb → 9%
• Anterior surface → 4.5%
• Posterior surface → 4.5%
• Anterior trunk (chest + abdomen) → 18%

• Posterior trunk (back + buttocks) → 18%
• Each lower limb → 18%
• Anterior surface → 9%
• Posterior surface → 9%
• Perineum / genitalia → 1%
How

• Assign the corresponding percentage to each area
• Add all values

• TBSA (%) = Sum of all burned area perce burn severity
• Guides IV fluid resuscitation
• Assists in triage decisions
• Helps decide burn center referral

Role in Fluid Resuscitation

• Parkland Formula
• 4 mL × body weight (kg) × % TBSA burned
• 50% given in first 8 hours
• Remaining 50% over next 16 hours

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