Emergency Preparedness & Response
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Emergency Preparedness and Response
Determining Total Body Surface Area
Wallace Rule of Nines and Palmer Method
PDF version for print: Determining Total Body Surface Area (PDF)
Courtesy of the American Burn Association.
Rule of Nines Adults (Age ≥ 14 years)
Role of Nines for Children (Age 1-14 years)
Rule of Nines for Infant (Age < 1 year)
Palmer Method
Estimate with fingers positioned together as above. Utilize the patient's palm size not your own.
The Palmer Method of estimating total body surface area (TBSA) is an easy way to get a rough burn size estimate that can be used when calculating a patients fluid resuscitation needs.
The patient’s palmar surface including their fingers = 1% TBSA
Courtesy of the American Burn Association.