Adult Burn TBSA Calculator (Rule of Nines)
Estimate qualifying adult burn total body surface area with classic Rule of Nines anterior and posterior segments.
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About
The Classic Adult Rule of Nines is a rapid approximation of qualifying burn total body surface area (TBSA), not ordinary height-and-weight body surface area. Its fixed adult segment proportions derive from the classic Rule of Nines and current burn-care teaching materials. [1, 2, 4]
It records only superficial partial-thickness, deep partial-thickness, and full-thickness area after an explicit adult whole-body assessment. This page cannot determine burn depth, mechanism, severity, referral needs, fluid needs, or prognosis. [2, 3]
Interpretation
Referral and resuscitation context — not calculated
Current American Burn Association referral guidance includes any full-thickness burn, partial-thickness burns at least 10% TBSA, deep partial-thickness or full-thickness burns at special sites, and inhalation, chemical, or high-voltage electrical injuries. Partial-thickness burns below 10% TBSA can also warrant consultation. These conditions cannot be determined from a TBSA number alone. [3]
The 2024 ABA burn-shock resuscitation guideline studied adults with burns at least 20% TBSA. That is a guideline study scope, not a dynamic high-risk label on this page. This calculator does not calculate fluids; the related Classic Parkland page is a separate historical 4 mL model and this estimate is not a fluid prescription. [5]
References
- Wallace AB. The exposure treatment of burns. Lancet. 1951;1(6653):501–504. PMID 14805109. DOI 10.1016/S0140-6736(51)91975-7.
- World Health Organization. Standards and recommendations for burns care in mass casualty incidents. 2024. Annex 2: adult Wallace Rule of Nines.
- American Burn Association. Guidelines for Burn Patient Referral.
- NSW Agency for Clinical Innovation. Burn size: total body surface area. February 2026.
- Cartotto R, et al. American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation. J Burn Care Res. 2024;45(3):565–589. PMID 38051821. DOI 10.1093/jbcr/irad125.
- Wachtel TL, et al. The inter-rater reliability of estimating the size of burns from various burn area chart drawings. Burns. 2000;26(2):156–170. PMID 10716359. DOI 10.1016/S0305-4179(99)00047-9.
- Livingston EH, Lee S. Percentage of burned body surface area determination in obese and nonobese patients. J Surg Res. 2000;91(2):106–110. PMID 10839957. DOI 10.1006/jsre.2000.5909.
- Pham C, Collier Z, Gillenwater J. Changing the Way We Think About Burn Size Estimation. J Burn Care Res. 2019;40(1):1–11. PMID 30247559. DOI 10.1093/jbcr/iry050.
FAQ
Each segment contribution is calculated with its submitted precision and summed before the total is displayed to one decimal place. This avoids changing the total by repeatedly rounding individual pieces.
Sources: [1]
Current ABA guidance includes partial-thickness burns at least 10% TBSA among referral considerations, but depth, special sites, mechanism, inhalation injury, and other factors matter. This page does not make a referral decision.
Sources: [3]
The 2024 ABA burn-shock resuscitation guideline studied adults with burns at least 20% TBSA. That study scope is not a personal severity category, and this calculator does not prescribe fluids.
Sources: [5]
Related Calculators
Parkland
Calculate the classic adult Parkland 4 mL/kg/%TBSA first-24-hour crystalloid estimate and its fixed 50/50 formula allocation.
Shock Index
Calculate traditional adult Shock Index from paired heart rate and systolic blood pressure.
BSA
Calculate estimated body surface area from height and weight using the Mosteller, Du Bois, or Haycock formula.
Disclaimer
Educational and informational reference only. Not intended to replace professional medical advice, diagnosis, treatment, or independent verification.