Calculate Total Body Surface Area (TBSA) of burns using the Rule of 9s. For clinicians assessing burn injuries.
Refer to a burns unit if any of the following apply:
Burns >10% TBSA in adults, or >5% TBSA in children or elderly
Full-thickness burns of any size · Burns to face, hands, feet, genitalia, perineum, or major joints · Circumferential burns · Chemical burns · Electrical burns (including lightning) · Burns with inhalation injury · Burns in patients with significant comorbidities · Burns in children (consider child protection) · Burns associated with major trauma
Contact your state burns unit for advice: QLD: Royal Brisbane (07 3646 8111) · NSW: Concord (02 9767 5000) · VIC: Alfred (03 9076 2000) · SA: Royal Adelaide (08 7074 0000) · WA: Fiona Stanley (08 6152 2222)
Parkland formula: 4 mL × body weight (kg) × %TBSA = total crystalloid (Hartmann's/Ringer's lactate) in the first 24 hours.
Give half in the first 8 hours from time of burn (not time of presentation), and the remaining half over the next 16 hours.
This is a starting point — titrate to urine output (adults: 0.5–1 mL/kg/hr, children: 1 mL/kg/hr). Fluid resuscitation is generally indicated for burns >15% TBSA in adults or >10% TBSA in children.