Rule of nines for burns

The rule of nines is a method doctors and emergency medical providers use to easily calculate the
treatment needs for a person who’s been burned.

It’s sometimes referred to as the Wallace rule of nines after Dr. Alexander Wallace, the surgeon who
first published the method. The creation of this method is credited to Pulaski and Tennison.

A medical professional will do a visual examination to look for seriously burned areas and use the rule of
nines to quickly add up what percentage of a person’s body is burned. While doctors will perform more
thorough examinations for burn estimation, they can use the rule of nines to quickly assess a person and
start recommending treatment centers and interventions to help a person.

The rule of nines is meant to be used for:

 second-degree burns, also known as partial-thickness burns

 third-degree burns, known as full-thickness burns

The rule of nines assigns a percentage that’s either nine or a multiple of nine to determine how much
body surface area is damaged. For adults, the rule of nines is:

 The front and back of the head and neck equal 9% of the body's surface area.
 The front and back of each arm and hand equal 9% of the body's surface area.
 The chest equals 9% and the stomach equals 9% of the body's surface area.
 The upper back equals 9% and the lower back equals 9% of the body's surface area.
 The front and back of each leg and foot equal 18% of the body's surface area.
 The genital area equals 1% of the body's surface area
Doctors don’t typically use the same calculations in the rule of nines to children. This is because children
tend to have different body proportions than adults do, including larger heads and smaller legs. For
example, children tend to proportionally have a 20 percent larger head than adults, according to
the National Institutes of Health. Infants also have 13 percent smaller legs than adults.

Therefore, there are a few adjustments for the rule of nines in children: