A tool to support the clinical decisions of doctors and health professionals, not for self-diagnosis or self-treatment.
This calculator is inside the patient's file in Clinicato: open it from "Medical tools" while you chart the visit, it fills in from the patient's details and vital signs where they are recorded, and adds its result to the visit's plan in one tap, with the "Medical tools" add-on. Try it in your clinic
Calculator
The result shows once you confirm, and a dose is always to be checked against the product label or your drug reference before use.
How it works and when to use it
The rule of nines: in adults the head 9%, each arm 9%, the front and back of the trunk 18% each, each leg 18% and the perineum 1%, in a young child the head 18% and each leg 14%, and superficial burns are not counted.
Parkland: 4 mL × weight × % burn over the first 24 hours from the time of the burn, half in the first 8 hours and the rest over 16 hours, and ABLS starts at 2 mL in adults and 3 mL in children, then adjusts to urine output.
Reference: Wallace AB. Lancet 1951 (rule of nines); Baxter CR, Shires T. Ann N Y Acad Sci 1968;150:874-94 (Parkland); American Burn Association, Advanced Burn Life Support (ABLS) 2018
Frequently asked questions
Why count from the time of the burn, not arrival?
Fluid loss starts when the burn happens, so after a late arrival half the volume goes in over what is left of the first 8 hours.
Is the rule of nines accurate for children?
It is an adjusted approximation, a Lund-Browder chart is more accurate as it follows how head and leg shares change with age.
Is the number final?
No, it is a starting point, and fluids are adjusted hour by hour to urine output: 0.5 mL/kg/h in adults and 1 mL/kg/h in children under 30 kg.
Tools you may also need
- ASA physical status classification The ASA class, its definition and examples.
- Glasgow Coma Scale (GCS) calculator The GCS total of 15, its components and severity.
- Maintenance fluids calculator (Holliday-Segar) Maintenance fluids in mL a day and an hour.
- Body surface area (BSA) calculator Body surface area in m² by two formulas.
- Ideal and adjusted body weight (Devine) Ideal weight, actual weight as a percentage of it, and adjusted weight.
- Mean arterial pressure (MAP) calculator Mean arterial pressure in mmHg.
Clinic software for this specialty
Try Clinicato for your clinic
These calculators are free here for everyone, and in Clinicato 49 medical tools work inside the patient's file with the "Medical tools" add-on: filled from the visit and the vital signs, with the result added to the visit's plan, next to appointments, prescriptions and invoices.