Burn Injury Classification | NurseNest

Educational use only. These estimates are not fluid or medication orders. Resuscitation is titrated to urine output, perfusion and clinical response under your local burn protocol and the direction of the burn team.

Most sources here are American Burn Association (ABA) guidance. Canadian provincial burn programs set their own protocols and referral pathways (for example, the BC provincial major-burns guideline published in BCMJ in 2012 used 3 mL/kg/%TBSA). Follow your local pathway.

Estimate burned body surface area (TBSA)

Method

Adult Rule of NinesPalmar methodLund-Browder (children and adults)

Age (years)

Adult chart: 14 years and older.

Burned fraction of each body region
Region (% of body)	Partial or full thickness	Superficial only
Head and neck (9%)
Right arm (9%)
Left arm (9%)
Anterior trunk (18%)
Posterior trunk (18%)
Right leg (18%)
Left leg (18%)
Perineum (1%)

Burn depth and burn-centre referral considerations

Burn depth features
Depth	Typical features	Healing (approximate)
Superficial (not counted in TBSA)	Epidermis only; red, dry, blanches, painful; no blisters.	Heals in about a week without scarring.
Superficial partial-thickness	Red, moist, blistered; blanches with pressure; very painful.	Usually heals within about 3 weeks with minimal scarring.
Deep partial-thickness	Yellow or white, drier; does not blanch; reduced sensation.	Heals over weeks with scarring; often needs grafting.
Full-thickness	White, brown or black, leathery and dry; no blanching; little or no pain.	Does not heal well on its own; needs grafting.

Partial-thickness area (% TBSA) – optional

Findings presentAny full-thickness burnDeep burn of face, hands, feet, genitalia, perineum or over a jointSuspected inhalation injuryFacial flash burn, singed facial hair or smoke exposureChemical injuryHigh-voltage (≥1,000 V) electrical injury or lightningLow-voltage electrical injurySignificant comorbiditiesAssociated traumatic injuryPoorly controlled painBurn that may be deep, any sizeChild (14 years or younger, or under 30 kg)

Referral considerations

No listed referral criterion selected — this is not clearance; reassess and follow local policy.

American Burn Association Guidelines for Burn Patient Referral (2022). Canadian provinces use their own burn-program referral pathways. An educational aid, not a diagnosis.

Burn Injury Classification

Introduction

Try the burn calculators

Burn Injury Classification

Introduction

Try the burn calculators

Estimate burned body surface area (TBSA)

Initial fluid-resuscitation estimates (first 24 hours)

Urine output during burn resuscitation

Burn depth and burn-centre referral considerations

Referral considerations

Quick Clinical Summary

Key Takeaways

Continue Your Learning

Check your understanding

Overview

Introduction

Try the burn calculators

Overview

Introduction

Try the burn calculators

Estimate burned body surface area (TBSA)

Initial fluid-resuscitation estimates (first 24 hours)

Urine output during burn resuscitation

Burn depth and burn-centre referral considerations

Referral considerations

Quick Clinical Summary

Key Takeaways

Continue Your Learning

Check your understanding