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Emergency Medicine & Critical CareAdult Burn TBSA

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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QuickMedCalc is developed and maintained by an independent developer. Medical content is not independently reviewed by a physician.

Formula and medical content are based on the references listed on this page. See sources, About, and Sources and Review Process.

Required assessment confirmations

Complete all three before calculating. Unselected segments are counted as 0 only after a complete, qualifying adult assessment is confirmed.

Adult Rule of Nines segments

Check an affected segment, then estimate the percentage of that fixed segment affected. 100% means the entire listed segment is affected.

Head and neck

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Upper limbs

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Anterior trunk

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Posterior trunk

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Lower limbs

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Enter the estimated percentage of this segment affected only when selected.

Perineum / genitalia

Enter the estimated percentage of this segment affected only when selected.

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]

Formula

Segment contribution = fixed adult segment TBSA weight × submitted segment coverage ÷ 100 [1, 2]
Estimated qualifying burn TBSA = sum of all unrounded segment contributions [1]
Classic adult Rule of Nines uses fixed anterior and posterior body segments totaling 100% [1, 4]

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

  1. Wallace AB. The exposure treatment of burns. Lancet. 1951;1(6653):501–504. PMID 14805109. DOI 10.1016/S0140-6736(51)91975-7.
  2. World Health Organization. Standards and recommendations for burns care in mass casualty incidents. 2024. Annex 2: adult Wallace Rule of Nines.
  3. American Burn Association. Guidelines for Burn Patient Referral.
  4. NSW Agency for Clinical Innovation. Burn size: total body surface area. February 2026.
  5. 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.
  6. 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.
  7. 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.
  8. 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.

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Disclaimer

Educational and informational reference only. Not intended to replace professional medical advice, diagnosis, treatment, or independent verification.