# Rule of Nines for burn estimates???

When someone says that 42% of a pt's arms and legs (each front and back), and 27% of the pts trunk (each front and back), do you multiply the percentages to the 36% noted on the Rule of Nines for burns?

Is it all or nothing? (forget the percents given.....if anything on the front and back of the torso is burned, it's 36%) if so, do I total it all up (36%+36%), then subtract from 100%?

My book does not give directions, and I can't find directions on the internet!!!!!!!
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3. Does anyone on this whole website know how to use the Rule of Nines????????????????????????????????????????????? ?????????????????

Quote from Fun2Care

When someone says that 42% of a pt's arms and legs (each front and back), and 27% of the pts trunk (each front and back), do you multiply the percentages to the 36% noted on the Rule of Nines for burns?

Is it all or nothing? (forget the percents given.....if anything on the front and back of the torso is burned, it's 36%) if so, do I total it all up (36%+36%), then subtract from 100%?

My book does not give directions, and I can't find directions on the internet!!!!!!!
4. Quote from Fun2Care
Does anyone on this whole website know how to use the Rule of Nines????????????????????????????????????????????? ?????????????????
My anatomy professor told us an example:
When boiling water spills out, and you are standing next to it you may protect yourself by crossing your arms in front of your chest. Let's say that your forearm and part of your front trunk got burn. You have to count like this: upper limb is 9%, you need about half of it on both arms, that is 9%. Front trunk is 18%, you need about half of it. 9%+9%=18%.
Here is another example next to the figure:
http://www.moondragon.org/health/disorders/burns.html
Katie
5. Thanks for your response. So, what you are saying is that I should mulitply the percentages given in the case study, to the percentages of the Rule of Nines to find the exact amount burned?

I don't know why I am making a mountain out of a molehill like this. I just wish I could find definate directions! :angryfire

Quote from LKG6
My anatomy professor told us an example:
When boiling water spills out, and you are standing next to it you may protect yourself by crossing your arms in front of your chest. Let's say that your forearm and part of your front trunk got burn. You have to count like this: upper limb is 9%, you need about half of it on both arms, that is 9%. Front trunk is 18%, you need about half of it. 9%+9%=18%.
Here is another example next to the figure:
http://www.moondragon.org/health/disorders/burns.html
Katie
6. By ignoring the percentages given, and just add the 9%'s up, I get 90%. (If I remember correctly from this morning.)

By using the percentages given, I get 31.4%.

Either way it is a 2nd degree burn over 25% of the patient's body, so medical attention is advised.

I just wish SOMEONE, ANYONE, could tell me which method of calculating the extent is correct.

:smackingf :selfbonk:
7. I feel for you

Our professor didn't go very in depth into the rule of nine's...just the basic breakdown ( 9% legs, 4.5% arms each, 18% trunk, etc etc- front and back each add up).

She was asked a pointed question about breakdown and what " burns of 50% of the body meant in terms of location ( b/c 50 isn't a directly divisible by 9) and she basically said 'You'd look at the body and know".

I mean - OK sure- but not really an answer you know? So, I feel for you.
8. Quote from BoonersMom
I feel for you

Our professor didn't go very in depth into the rule of nine's...just the basic breakdown ( 9% legs, 4.5% arms each, 18% trunk, etc etc- front and back each add up).

She was asked a pointed question about breakdown and what " burns of 50% of the body meant in terms of location ( b/c 50 isn't a directly divisible by 9) and she basically said 'You'd look at the body and know".

I mean - OK sure- but not really an answer you know? So, I feel for you.

EXACTLY!!! At least if I was able to see the pt. I'd have a general idea. lol
9. Fun2Care,
What does your professor say? How does s/he explain the rule of nines? Does s/he give any examples, details?
Katie
10. Quote from LKG6
Fun2Care,
What does your professor say? How does s/he explain the rule of nines? Does s/he give any examples, details?
Katie

My professor won't answer because it is a 25% of our lab practical grade. He said, and it is written in the syllabus, that we can help each other, but we must turn in our own papers. However, no one really knows exactly. The book doesn't go into detail. It just has the usual picture, with the 9%'s marked around the body.

The small amount about burns doesn't say whether or not the tissues have been killed either. It just says "damaged", and a 3rd degree is "destroyed". BUT...I have read in several articles that the cells die with all burns.

This all just confuses me so much. :selfbonk:
11. I'm not sure if this is still an issue since you were discussing this in February, but in my experience and classwork the "Rule of Nines" is just an estimate. I don't know what percentages or formulas you are getting from professors, but in the practical setting they are useless... at least in my field. I am a paramedic in Indiana. Rule of Nines is important for determining fluid resuscitation via the Parkland formula. But simply put, it's all guesswork. If you have half of the anterior trunk burned (about 9 %), circumfirential burns to both arms(about 9% each), and burns on the left side of the face (about 4.5%), then you have approximately 31.5% BSA burned. No, it isn't divisible by nine. Nine is just an easy way to remember all the different percentages of the body so that you can estimate body surface area burned. I'm not sure if this is what you were asking or if it helps. If it is what you were trying to figure out, I hope it helps... if not in your class, then in your work.

Jeremy Belwood
NREMTP, CCEMTP