Wallace rule of nines
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| Body Part | Estimated BSA | |
|---|---|---|
| Adults | Children | |
| Entire left arm | 9% | 9% |
| Entire right arm | 9% | 9% |
| Head & neck | 9% | 18% |
| Entire chest | 9% | 9% |
| Entire abdomen | 9% + 1% (Genitals) |
9% |
| Entire back | 18% | 18% |
| Entire left leg | 18% | 14% |
| Entire right leg | 18% | 14% |
The Wallace rule of nines is a tool used in pre-hospital and emergency medicine to estimate the total body surface area (BSA) affected by a burn. In addition to determining burn severity, the measurement of burn surface area is important for estimating patients' fluid requirements and determining hospital admission criteria.[1]
The rule of nines was devised by Pulaski and Tennison in 1947, and published by Alexander Burns Wallace in 1951.[2]
To estimate the body surface area of a burn, the rule of nines assigns BSA values to each major body part:[3]
This allows the emergency medical provider to obtain a quick estimate of how much body surface area is burned. For example, if a patient's entire back (18%) and entire left leg (18%) are burned, about 36% of the patient's BSA is affected.
The BSAs assigned to each body part refer to the entire body part.[4] So, for example, if half of a patient's left leg were burned, it would be assigned a BSA value of 9% (half the total surface area of the leg). Thus, if a patient's entire back (18%), but only half of their left leg (9%) was burned, the amount of BSA affected would be 27%.
