🧑‍⚕️ Patient Setup

All profiles use age-adjusted Lund-Browder regions. A whole-region tap assumes that entire marked area is burned.
Drives the Parkland fluid calculation.
1° (superficial) is shown but not counted in TBSA.
🔥 Live TBSA
Counted depth: 2° + 3°
Total
0.0%

Classical 4 mL training example, not a fluid order. Current ABA adult guidance and referral criteria are explained below; pediatric care requires its own protocol.

Classical Parkland example (24h)
— 4 mL × kg × %TBSA
First 8 h
— 1/2 of total
First 8 h drip
— mL/hour
Next 16 h drip
— mL/hour
Referral needs clinical assessment; the diagram cannot rule out consultation.
Selected Regions
0
  • No regions tapped yet.

Body Diagram — Tap to Mark Burns

Each tap cycles depth
1° (info)2° partial3° full
HeadNAnt. TrunkR-UAL-UAR-FAL-FAR-HL-HGR-ThL-ThR-LgL-LgR-FtL-Ft

Tap a region with your selected depth to mark it. Tapping the same region cycles through depths and clears. Front and back surfaces of the same region count separately (e.g. front of arm vs back of arm = ½ each).

What Is TBSA?

Total Body Surface Area (TBSA) is the percentage of a patient's body affected by partial-thickness (2°) and full-thickness (3°) burns. It is the single most important number driving fluid resuscitation, transfer to a burn center, and prognosis. Superficial (1°) burns are not counted toward TBSA.

TBSA is estimated in the field using one of three methods: the Rule of Nines for adults, the Lund-Browder chart for pediatric patients (because children have proportionally larger heads and smaller legs), and the palmar method for small or scattered burns (the patient's palm including fingers is approximately 1% TBSA).

9%
Each arm (Rule of Nines)
18%
Each leg (Rule of Nines)
18%
Anterior trunk
1%
Patient palm (palmar method)
≥20%
ABA adult burn-shock guideline scope
≥10%
Partial-thickness consultation criterion

Rule of Nines (Adult)

The Rule of Nines is a quick adult reference: head and neck 9%, each entire arm 9%, each entire leg 18%, anterior trunk 18%, posterior trunk 18%, and perineum 1%. The interactive diagram above uses the more detailed Lund-Browder regions instead; boundaries and regional totals differ.

Head + Neck — 9%
Front + back combined
Anterior trunk — 18%
Chest + abdomen
Posterior trunk — 18%
Upper + lower back
Each arm (entire) — 9%
Front 4.5% + back 4.5%
Each leg (entire) — 18%
Front 9% + back 9%
Genitalia / perineum — 1%
Single region

Lund-Browder Chart (Pediatric)

Children have proportionally larger heads and smaller legs than adults — the infant Lund-Browder head region is 19%, compared with 7% in the adult Lund-Browder profile (neck is separate). Lund-Browder adjusts head, thigh, and lower leg percentages by age. All other regions stay relatively stable.

Region<1 yr1–45–910–1415Adult
Head1917131197
Neck222222
Ant. trunk131313131313
Post. trunk131313131313
Each buttock2.52.52.52.52.52.5
Genitalia111111
Each upper arm444444
Each forearm333333
Each hand2.52.52.52.52.52.5
Each thigh5.56.588.599.5
Each lower leg555.566.57
Each foot3.53.53.53.53.53.5

This calculator switches the underlying Lund-Browder percentages when you select an age profile, including the adult profile. The body diagram itself stays the same — only the numbers change.

Classical Parkland Formula — Training Comparison

Parkland formula: 4 mL × patient weight (kg) × %TBSA = total Lactated Ringer's volume for the first 24 hours from the time of injury. Half is given over the first 8 hours; the remaining half over the next 16 hours.

This tool retains the classical 4 mL calculation for teaching. It is not a universal current treatment recommendation. The ABA adult burn-shock guideline recommends starting at 2 mL/kg/%TBSA for adults with burns at least 20% TBSA, with clinical titration. Pediatric treatment needs its own protocol. The values shown here do not account for fluid already given, delayed presentation, maintenance needs or response to treatment.

Worked example — 80 kg adult, 30% TBSA
Total = 4 × 80 × 30 = 9,600 mL over 24 h.
First 8 h: 4,800 mL (≈ 600 mL/h drip).
Next 16 h: 4,800 mL (≈ 300 mL/h drip).
Clock starts at time of injury, not arrival.
Important caveats
TBSA and burn depth need clinical reassessment. The displayed historical hourly averages are not infusion orders and do not calculate a catch-up rate. Clinical monitoring, fluid already administered and pediatric maintenance needs require medical direction; consult the receiving burn center.

Burn Center Referral Criteria

The ABA referral guidelines distinguish immediate consultation with consideration for transfer from other consultation recommendations. The summary below does not replace the full criteria or local medical direction.

Partial-thickness ≥10% TBSA
Immediate consultation with consideration for transfer.
Any full-thickness burns
Even small full-thickness burns warrant referral.
Deep burns in critical areas
Deep partial or full-thickness injury of the face, hands, feet, genitalia, perineum or over joints.
High-voltage electrical injury or lightning
Immediate consultation with consideration for transfer; other electrical injuries also need consultation and follow-up.
Chemical burns
Especially HF, alkali, or unknown agents.
Inhalation injury
Suspected from soot, hoarseness, stridor, closed-space fire.
Burn + concomitant trauma
Stabilize trauma first if life-threatening.
Pediatric patients
All pediatric burns may benefit from burn-center referral.
Significant comorbidities
Cardiac, pulmonary, diabetic, immunocompromised.

Burn TBSA & Parkland FAQ

Count partial- and full-thickness burn area. Superficial redness alone is not included. Clinical assessment of depth and affected area is still required; tapping a whole diagram region can overstate a smaller burn.

The interactive diagram uses age-adjusted Lund-Browder region percentages, including an adult profile. Rule of Nines is explained separately as a quick adult reference; its broad regional boundaries differ from the diagram. Front and back taps count the displayed half of a split region.

The historical 4 mL × weight in kg × percent TBSA formula gives an illustrative 24-hour volume, with half in the first 8 hours from injury and half in the next 16. This calculator shows that arithmetic for education, not a patient-specific fluid order. It does not subtract fluids already given or calculate a delayed-arrival catch-up rate.

No. The ABA burn-shock clinical practice guideline recommends a 2 mL/kg/%TBSA starting volume for adults with burns at least 20% TBSA, followed by clinical titration. That recommendation does not prescribe pediatric treatment. Follow local medical direction and the receiving burn center.

ABA guidance calls for immediate consultation with consideration for transfer for partial-thickness burns at least 10% TBSA, full-thickness burns and other specified injuries or patient factors. Smaller and potentially deep burns also warrant consultation; all pediatric burns may benefit from referral. Review the full criteria rather than relying on a TBSA threshold alone.

The patient's entire palmar hand surface, including fingers, is commonly used as an approximate 1% reference for small or scattered areas. It is an approximation, not a precise measurement, and the patient's own hand is the reference.

No. Depth, location, inhalation injury, mechanism, comorbidities, trauma, pain and pediatric needs can change the referral decision. The calculator cannot assess all of these and must not rule out consultation.

No. The classical Parkland example does not include maintenance fluid, glucose needs, fluid already given or response-based titration. Pediatric treatment requires a separate approved protocol and clinical assessment.
Training and operational reference only. Not a medical device. Not FDA-cleared. Not a substitute for clinical judgment. Always follow your agency's burn protocol and your medical director's guidelines. Editorial policy · Our authors