1. Burn Injuries Rule of Nines
Integumentary System
Burn Injuries
Rule of Nines

2. Burns
“Injury caused by fire, heat, chemical agents, radiation, and/or electricity”
3 classifications
1st degree (Superficial burn)
2nd degree (Partial-thickness)
3rd degree (Full-thickness)

3. 1st Degree Reddened skin; mild swelling; painful
Least severe (low risk for infection)
Involves only epidermis
5-6 day healing time
Causes = sunburn, brief exposure to hot temp.
Tx = remove heat source; cool water 15 min.

4. 1st Degree Burn

5. 2nd Degree (Partial Thickness)
Injury to epidermis/dermis
Reddened skin; blisters; pain; swelling
3-4 weeks healing time
Causes = sunburn, fire, exposure to hot liquids
Tx =
Mild = Same as 1st degree; don’t break blisters
Severe = Cover with gauze; ER

6. 2nd Degree Burns

7. 3rd Degree (Full Thickness)
Most severe
Injury to all layers of skin + muscle & nerves
Skin appears white / charred
Painless
High risk = infection, shock, dehydration
Causes = fire, electricity, immersion of hot liquids
Tx = 911; Cover with thick, sterile gauze; watch for shock; do not remove clothing; watch ABC’s

8. 3rd Degree Burns

9. Rules for Burns Do not use ice Do not apply cotton/tissues
Do not break blisters
Do not use oil based ointments
Do not remove clothing (3rd)
Chemical burns, min. of water
911 for burns 15% (adult); 10% (child)

10. Rule of Nine Calculate % of body surface burned Head 4 ½ %
Chest / Abs 18 % (9 each)
Arms 4 ½ (each)
Legs 9% (each)
Back 18%
Groin 1%

11. Examples
A 9 year old boy is burned by touching a hot pan. His front L arm is red with blisters. What % of body surfaced is burned?
A man fall asleep while the stove is on. He wakes up to flames. His back and chest are burned. What % of body surface is burned?