Alexander Wallace, the surgeon who first published the method. The creation of this method is credited to Pulaski and Tennison. 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. For adults, the rule of nines is:. A medical provider can use calculations from the rule of nines in several ways. This includes the amount of fluid replacement and degree of care a person needs. When a person experiences a second-degree burn or worse, the protective layer of skin is destroyed.
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. The rule of nines was devised by Pulaski and Tennison in , and published by Alexander Burns Wallace in To estimate the body surface area of a burn, the rule of nines assigns BSA values to each major body part: . This allows the emergency medical provider to obtain a quick estimate of how much body surface area is burned. The BSAs assigned to each body part refer to the entire body part. Some studies have raised concerns about the rule of nines' accuracy with obese patients, noting that "the proportional contribution of various major body segments to the total body surface area changes with obesity. Other studies have found that the rule of nines tends to over-estimate total burn area,  and that ratings can be subjective,  but that it can be performed quickly and easily, and provide reasonable estimates for initial management of burn patients. The rule of nines was designed for adult patients. The remainder of the body parts retain the same BSA percentages used in the adult rule of nines.
Federated Search Page Form block
NCBI Bookshelf. Ross A. Moore ; Abdul Waheed ; Bracken Burns. Authors Ross A. Moore 1 ; Abdul Waheed ; Bracken Burns 2. This tool is only utilized for second-degree and third-degree burns also referred to as partial thickness and full thickness burns and aids the provider in quick assessment to determine the severity and intravenous fluid needs. The Rule of Nines has been shown to be the most frequently recited algorithm by physicians and nurses for estimating burn surface area in numerous studies. The Rule of Nines estimation of body surface area burned is based on assigning percentages to different body areas. Each upper extremity can further be divided into anterior 4.
Jump to content. You can quickly estimate the size of a burn by using the "rule of nines. See a picture of the "rule of nines" for adults. See a picture of the "rule of nines" for babies and young children. The "rule of palm" is another way to estimate the size of a burn. Use the person's palm to measure the body surface area burned. It can be hard to estimate the size of a burn.