Tap the body diagram to mark burns. Get TBSA%
using Rule of Nines (adult) or
Lund-Browder (pediatric), with auto
Parkland Lactated Ringer's volume and
EMS handoff card export.
TBSA: 0.0%Parkland: —Profile: AdultTraining reference only
Tap a region to cycle depth: 2° → 3° → off ·
F/B Front/Back ·
P Print handoff
🧑⚕️ Patient Setup
Pediatric profiles use age-adjusted regional percentages.
Drives the Parkland fluid calculation.
1° (superficial) is shown but not counted in TBSA.
🔥 Live TBSA
Counted depth: 2° + 3°
Total
0.0%
Parkland total (24h)
— 4 mL × kg × %TBSA
First 8 h
— 1/2 of total
First 8 h drip
— mL/hour
Next 16 h drip
— mL/hour
✅ Below burn-center referral threshold (criteria: ≥10% TBSA peds, ≥20% adult, or any 3°).
Selected Regions
0
No regions tapped yet.
Body Diagram — Tap to Mark Burns
Each tap cycles depth
1° (info)2° partial3° full
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%
Adult Parkland threshold
≥10%
Pediatric Parkland threshold
Rule of Nines (Adult)
The Rule of Nines divides the adult body into 11 regions of 9% (or multiples of 9%) plus a 1% region for the genitalia. The total equals 100%. It is fast, easy to remember, and accurate for field use.
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 — a 1-year-old's head is approximately 19% TBSA versus 9% in adults. Lund-Browder adjusts head, thigh, and lower leg percentages by age. All other regions stay relatively stable.
Region
<1 yr
1–4
5–9
10–14
15
Adult
Head
19
17
13
11
9
7
Neck
2
2
2
2
2
2
Ant. trunk
13
13
13
13
13
13
Post. trunk
13
13
13
13
13
13
Each buttock
2.5
2.5
2.5
2.5
2.5
2.5
Genitalia
1
1
1
1
1
1
Each upper arm
4
4
4
4
4
4
Each forearm
3
3
3
3
3
3
Each hand
2.5
2.5
2.5
2.5
2.5
2.5
Each thigh
5.5
6.5
8
8.5
9
9.5
Each lower leg
5
5
5.5
6
6.5
7
Each foot
3.5
3.5
3.5
3.5
3.5
3.5
This calculator switches the underlying region percentages automatically when you select a pediatric profile from the patient setup panel. The body diagram itself stays the same — only the numbers change.
Parkland Formula — Fluid Resuscitation
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.
The Parkland formula is the most widely taught fluid resuscitation guide for major thermal burns. It is intended for partial- and full-thickness burns covering ≥20% TBSA in adults or ≥10% TBSA in children. Lactated Ringer's is the preferred isotonic crystalloid because it more closely matches plasma electrolyte composition than normal saline and avoids hyperchloremic acidosis at large volumes.
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
Field TBSA estimates routinely overshoot, leading to over-resuscitation. Titrate to urine output (0.5 mL/kg/h adult, 1 mL/kg/h pediatric <30 kg). Add maintenance fluid for children. Inhalation injury, electrical burns, and delayed presentation often require more — discuss with medical control or burn center early.
Burn Center Referral Criteria
The American Burn Association lists the following criteria for transfer to a verified burn center. If any apply, contact your regional burn center early — even before TBSA is finalized.
Partial-thickness >10% TBSA
Across any age group.
Any full-thickness burns
Even small full-thickness burns warrant referral.
Face, hands, feet, genitalia, perineum, major joints
Functional and cosmetic outcomes are at risk.
Electrical burns
Includes lightning. Internal injury often exceeds visible.
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
At any facility lacking pediatric burn capability.
Significant comorbidities
Cardiac, pulmonary, diabetic, immunocompromised.
Burn TBSA & Parkland FAQ
Total Body Surface Area (TBSA) is the percentage of a patient's body affected by partial-thickness (2nd degree) and full-thickness (3rd degree) burns. Superficial (1st degree) burns are not counted toward TBSA. TBSA% drives fluid resuscitation decisions, transfer criteria, and burn center referral. The two main estimation methods are the Rule of Nines for adults and the Lund-Browder chart for pediatric patients.
The Rule of Nines is a quick TBSA estimation method for adults that divides the body into regions of 9% or multiples of 9%: head 9%, each entire arm 9%, anterior trunk 18%, posterior trunk 18%, each entire leg 18%, and genitalia 1%. Total equals 100%. It is fast, easy to remember, and accurate enough for field use, but it overestimates TBSA in children whose head is proportionally larger.
Use the Lund-Browder chart for any patient under 15 years old. Children's body proportions differ from adults — a 1-year-old's head is approximately 19% TBSA versus 9% in adults, and the legs are smaller. Lund-Browder adjusts regional percentages by age bracket (under 1, 1–4, 5–9, 10–14, ≥15) to give a more accurate estimate. This calculator switches automatically when you select a pediatric patient.
The Parkland formula calculates initial fluid resuscitation for major burns: 4 mL × patient weight in kg × %TBSA = total Lactated Ringer's volume for the first 24 hours. Half is given over the first 8 hours from the time of injury, the remaining half over the next 16 hours. The formula is intended for partial- and full-thickness burns covering ≥20% TBSA in adults or ≥10% in children.
No. Superficial (1st degree) burns — like sunburn — are not counted in TBSA calculations because they do not cause significant fluid loss or systemic response. Only partial-thickness (2nd degree) and full-thickness (3rd degree) burns are included. This calculator excludes 1st degree burns from the TBSA total automatically.
American Burn Association criteria for burn center transfer include: partial-thickness burns >10% TBSA, any full-thickness burns, burns involving face/hands/feet/genitalia/perineum/major joints, electrical or chemical burns, inhalation injury, burns in patients with comorbidities, pediatric burns at facilities lacking pediatric care, and any burn with concomitant trauma. This calculator flags TBSA values that meet referral thresholds.
The palmar method estimates TBSA for small or scattered burns by using the patient's palm (including fingers) as approximately 1% of their body surface area. It is most useful for burns under 10% TBSA or for patchy distributions where the Rule of Nines is too coarse. For larger burns, use the Rule of Nines or Lund-Browder for accuracy.
Field estimates routinely overestimate TBSA by 50–100% compared to burn center assessments, especially for partial-thickness burns where erythema is mistaken for partial-thickness depth. Use this calculator as a starting point for fluid initiation, but expect adjustment at the receiving facility. Underestimation is rare; overestimation leading to fluid overload is the more common error.
Yes — intact blisters indicate partial-thickness injury and are included in TBSA. Do not count erythema alone (no blister, blanches with pressure, no skin loss) as that is superficial 1st degree and excluded. The presence of blisters, weeping skin, or skin separation marks the partial-thickness threshold.
No. This is an educational and operational reference tool for firefighter and EMS training. It is not a medical device, not FDA-cleared, and not a substitute for clinical judgment. Always follow your agency's burn assessment protocol and your medical director's guidelines. Real patient care requires direct provider evaluation.
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.
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