The Rule of Nines in adults, including women, is a method used to quickly estimate the total body surface area (TBSA) percentage that has been burned. It assigns percentage values to different body regions, with each region representing either 9% or a multiple of 9% of the total body surface.
Here's how the Rule of Nines breaks down for an adult, and applies equally to women:
- Head: 9% (entire head)
- Each Arm: 9% (entire arm)
- Anterior Trunk (chest and abdomen): 18%
- Posterior Trunk (back): 18%
- Each Leg: 18% (entire leg)
- Perineum: 1%
Table Summarizing the Rule of Nines (Adults)
| Body Region | Percentage of TBSA |
|---|---|
| Head | 9% |
| Each Arm | 9% |
| Anterior Trunk | 18% |
| Posterior Trunk | 18% |
| Each Leg | 18% |
| Perineum | 1% |
How to Use the Rule of Nines:
To estimate the burn percentage, simply add up the percentages for each burned area. For example, if a woman has burns covering her entire anterior trunk and her entire right arm, the estimated TBSA burned would be 18% (anterior trunk) + 9% (right arm) = 27%.
Important Considerations:
- It's an Estimate: The Rule of Nines provides a quick estimate and should be used as a starting point. More precise methods may be necessary in a clinical setting.
- Modified for Children: The Rule of Nines is modified for children because their body proportions are different (larger head, smaller legs). The values provided in the initial reference for children do not apply to adults.
- Palm Method: For smaller, scattered burns, the size of the patient's palm (including fingers) is approximately 1% of their TBSA, which can be helpful for estimating.
The Rule of Nines is a valuable tool for healthcare professionals to quickly assess the severity of burns, guide fluid resuscitation, and determine the appropriate level of care required for a burn patient.
