Burn Percentage in Adults: Rule of Nines

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Medical Editor: Benjamin C. Wedro, MD, FAAEM

The rule of nines assesses the percentage of burn and is used to help guide treatment decisions including fluid resuscitation and becomes part of the guidelines to determine transfer to a burn unit.

You can estimate the body surface area on an adult that has been burned by using multiples of 9.

An adult who has been burned, the percent of the body involved can be calculated as follows:

• Head = 9%
• Chest (front) = 9%
• Abdomen (front) = 9%
• Upper/mid/low back and buttocks = 18%
• Each arm = 9% (front = 4.5%, back = 4.5%)
• Groin = 1%
• Each leg = 18% total (front = 9%, back = 9%)

As an example, if both legs (18% x 2 = 36%), the groin (1%) and the front chest and abdomen were burned, this would involve 55% of the body.

Medically reviewed by Benjamin C. Wedro, MD, FAAEM

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