Rule of Nines (paediatric)
Last reviewed 01/2018
The Rule of Nines in inaccurate in children due to the relative disproportion of body parts:
- hips and legs are smaller
- head, neck and shoulders are larger
Hence, a paediatric version is available in chart form that estimates burn area as it changes with age. Alternatively, an estimate can be made from the following for a child up to the age of one year:
- head and neck total for front and back: 18%
- thorax and abdomen front: 18%
- thorax and abdomen back: 18%
- each upper limb total for front and back: 9%
- each lower limb total for front and back: 14%
Over the age of one year, the relative percentage of body surface area changes:
- the head decreases by 1% per year
- the lower limbs each increase by 0.5% per year
Hence, by the age of ten years the relative proportions assume the values for adult surface area:
- perineum becomes 1%
- each lower limb becomes a total of 18% for front and back
- head and neck become 9% total for front and back