Rule of 9’s
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Rule of 9’s estimates the total surface area that was burned
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- Whole leg is 18 % so front of leg = 9% and back of leg = 9%
- Whole arm is 9% so front of arm is 4.5 and back of arm = 4.5 %
- Head= 9% so face = 4.5% and back of head 4.5%.
- You will be given areas that were burned and you will need to determine the % body surface area.
- Again, rule of 9’s estimates BSA or body surface area that was burned
Try this problem
- Client has the entired back burned, the groin, the entire anterior leg, and the posterior portion of the right arm. Calculate TBSA using rule of 9’s.
- Back = 18%
- Groin = 1%
- Anterior leg = 9%
- Posterior arm = 4.5%
- Add it up: = 32.5%
Why we need Total Body Surface Area? To us Parkland Burn formula for fluid replacement
- Lactated Ringers is the IV fluid of choice
- Formula = 4mL X TBSA % X weight in kg = total fluid replacement needed in next 24 hours
- Give 1/2 volume in the first 8 hours and 1/2 volume in the second 16 hours
- Let’s supposed a client weighs 70 kgs and has a body surface area that was burned = 32.5%:
- 4 mL X 32.5 X 70 = 9,100 mL of LR in 24 hours
- Give 4,550 mL in the next 8 hours and then 4,550 in the next 16 hours