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The Wallace rule of nines is a tool used in pre-hospital and emergency medicine to estimate the total body surface area (BSA) affected by a burn. In addition to determining burn severity, the measurement of burn surface area is important for estimating patients' fluid requirements and determining hospital admission criteria.
Total body surface area (TBSA) is an assessment of injury to or disease of the skin, such as burns or psoriasis. In adults, the Wallace rule of nines can be used to determine the total percentage of area burned for each major section of the body.
Recent analysis of mortality in burn units worldwide has shown that for well performing units the LD50 (the point at which 50% of patients would be expected to die) for major burns has significantly improved and the best units have a modified Baux score of 130-140. This means that all burns in children (except 100% TBSA full-thickness burns ...
The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected. It was created by Dr. Charles Lund, Senior Surgeon at Boston City Hospital , and Dr. Newton Browder, based on their experiences in treating over 300 burn victims injured at the Cocoanut Grove fire in Boston in 1942.
Rule of nines or rule of nine may refer to: Rule of nine (linguistics), an orthographic rule of the Ukrainian language. Rule of nines (mathematics), a test for divisibility by 9 involving summing the decimal digits of a number; Wallace rule of nines, used to determine the percentage of total body surface area affected when assessing burn injuries
There are a number of methods to determine the TBSA, including the Wallace rule of nines, Lund and Browder chart, and estimations based on a person's palm size. [11] The rule of nines is easy to remember but only accurate in people over 16 years of age. [ 11 ]
The first half of this amount is delivered within eight hours from the burn incident, and the remaining fluid is delivered in the next 16 hours. [ 6 ] The burn percentage in adults can be estimated by applying the Wallace rule of nines (see total body surface area ): 9% for each arm, 18% for each leg, 18% for the front of the torso , 18% for ...
The rule estimates nine per cent for the head and each arm, 18 per cent each for lower limbs and front and back of the trunk, and 1 per cent for the perineal region. The extent of a burn is expressed as the percentage of the body surface area affected called the total burn surface area (TBSA). The TBSA is used to help calculate the volume of ...