Wallace rule of nines

Wallace Rule of Nines

Diagram illustrating the Wallace Rule of Nines

The Wallace Rule of Nines is a method used in the assessment of burns in patients. It provides a quick and systematic way to estimate the total body surface area (TBSA) affected by burns, which is crucial for determining the severity of the burn and guiding treatment decisions.

Description

The Wallace Rule of Nines divides the body into sections, each representing approximately 9% (or a multiple thereof) of the total body surface area. This method is particularly useful in emergency situations where rapid assessment is necessary. The body is divided as follows:

• The head and neck account for 9% of the TBSA.
• Each arm accounts for 9% of the TBSA.
• The anterior trunk (front of the torso) accounts for 18% of the TBSA.
• The posterior trunk (back of the torso) accounts for 18% of the TBSA.
• Each leg accounts for 18% of the TBSA.
• The perineum accounts for 1% of the TBSA.

Application

The Wallace Rule of Nines is primarily used in the initial assessment of burn patients. It helps healthcare providers quickly estimate the extent of burns and make decisions regarding fluid resuscitation and other critical interventions. This method is most accurate for adults, as the proportions of body surface area differ in children.

Limitations

While the Wallace Rule of Nines is a useful tool, it has limitations. It is less accurate for children due to their different body proportions. For pediatric patients, the Lund and Browder chart is often used as it provides a more detailed assessment. Additionally, the Rule of Nines may not be as precise for individuals with atypical body shapes or sizes.

Related pages

• Burn
• Lund and Browder chart
• Total body surface area
• Fluid resuscitation