What are the rules of nine. Rule of Nines for Burns: A Comprehensive Guide to Assessing Burn Severity

08.05.202108.06.2023 by alexxlab

How does the rule of nines help assess burn severity. What are the differences in applying the rule of nines to adults and children. Why is accurate burn assessment crucial for determining treatment needs.

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Understanding the Rule of Nines: A Vital Tool in Burn Assessment

The rule of nines is a critical method used by medical professionals to rapidly assess the severity of burns in patients. This technique allows for quick estimation of the total body surface area (TBSA) affected by second-degree (partial-thickness) or third-degree (full-thickness) burns. By assigning percentages in multiples of nine to different body regions, healthcare providers can swiftly determine the extent of burn injuries and initiate appropriate treatment protocols.

Origins of the Rule of Nines

While commonly referred to as the Wallace rule of nines, named after Dr. Alexander Wallace who first published the method, its creation is actually credited to Pulaski and Tennison. This system has become an invaluable tool in emergency medicine and burn care, enabling rapid triage and treatment planning for burn victims.

Applying the Rule of Nines in Adult Burn Assessment

For adult patients, the rule of nines divides the body into sections, each representing 9% or a multiple of 9% of the total body surface area:

Head and neck: 9%
Each arm: 9%
Chest: 9%
Abdomen: 9%
Upper back: 9%
Lower back: 9%
Each leg: 18%
Genitals: 1%

This breakdown allows for quick mental calculations, enabling healthcare providers to estimate the TBSA affected by burns efficiently.

Clinical Significance of TBSA Calculations in Burn Management

The percentage of TBSA affected by burns plays a crucial role in determining the course of treatment and the level of care required. Here are some key considerations:

Fluid Resuscitation

Burns exceeding 20-25% TBSA necessitate significant intravenous fluid replacement. The rule of nines helps in calculating the volume of fluids needed to maintain adequate hydration and prevent complications related to fluid loss.

Severity Assessment

Burns covering more than 30% TBSA can be potentially fatal, underscoring the importance of accurate assessment. The rule of nines provides a quick way to identify life-threatening burn injuries.

Specialized Care Requirements

Burn injuries affecting 10% or more of TBSA typically require treatment at a specialized burn center. The rule of nines helps in making this crucial decision rapidly.

Adapting the Rule of Nines for Pediatric Burn Assessment

Children’s body proportions differ significantly from adults, necessitating adjustments to the rule of nines for accurate burn assessment in pediatric patients. The key differences include:

Head: Comprises a larger proportion (20% larger than in adults)
Legs: Proportionally smaller (13% smaller than in adults)

These anatomical differences lead to the following adjustments in the pediatric rule of nines:

Head and neck: 18%
Each arm: 9%
Chest and abdomen: 18%
Back: 18%
Each leg: 14%

Special Considerations in Burn Assessment and Management

While the rule of nines is an invaluable tool, certain factors warrant special attention in burn assessment and treatment:

Location of Burns

Burns involving critical areas such as hands, feet, genitalia, face, or major joints require specialized care, regardless of the TBSA affected.

Type of Burns

Chemical and electrical burns necessitate specialized treatment approaches, often requiring management at a burn center.

Depth of Burns

The presence of third-degree burns, even if limited in extent, may necessitate treatment at a specialized burn facility.

Importance of Accurate Burn Assessment in Treatment Planning

Precise estimation of burn severity using the rule of nines is crucial for several aspects of patient care:

IV Access Requirements

Burns affecting 15% or more TBSA require at least one peripheral IV line, while burns covering 40% or more TBSA necessitate a minimum of two IV lines for adequate fluid resuscitation.

Fluid Replacement Calculations

The estimated TBSA guides the calculation of fluid replacement needs, crucial for maintaining hemodynamic stability and preventing complications associated with fluid loss in burn patients.

Triage and Facility Selection

Accurate assessment helps in determining whether a patient requires treatment at a specialized burn center or can be managed at a general hospital.

Limitations and Considerations of the Rule of Nines

While the rule of nines is a valuable tool, it’s important to recognize its limitations:

It provides an estimate, not an exact measurement of burn surface area
Accuracy may be affected in patients with non-standard body proportions
It doesn’t account for the depth of burns, which is also crucial in determining treatment
Regular reassessment is necessary as burn injuries can evolve over time

Healthcare providers often use the rule of nines in conjunction with other assessment methods for a more comprehensive evaluation of burn injuries.

Advancements in Burn Assessment Techniques

While the rule of nines remains a cornerstone in initial burn assessment, technological advancements have introduced new methods to complement and enhance burn evaluation:

3D Imaging and Computer-Assisted Measurement

Advanced imaging techniques and software can provide more precise measurements of burn surface area, especially useful in complex cases or for research purposes.

Telemedicine in Burn Assessment

Remote consultation using high-resolution images and video calls allows burn specialists to assist in assessment and treatment planning, even from distant locations.

Biomarkers and Laboratory Tests

Emerging research is exploring the use of specific biomarkers and laboratory tests to assess burn severity and predict outcomes, potentially complementing visual assessment methods like the rule of nines.

These advancements aim to improve the accuracy of burn assessment and enhance treatment outcomes for burn patients. However, the rule of nines remains an essential tool, particularly in emergency situations where rapid assessment is crucial.

Training and Education in Burn Assessment

Proper application of the rule of nines requires training and experience. Healthcare providers, particularly those in emergency medicine, critical care, and burn units, undergo specific training in burn assessment techniques. This training typically includes:

Practical exercises in estimating burn surface area using the rule of nines
Case studies and simulations to improve accuracy in varied scenarios
Education on the limitations and potential pitfalls of the method
Instruction on adapting the rule for different patient populations (adults, children, obese patients)

Continuous education and practice are essential for maintaining proficiency in burn assessment, ensuring that healthcare providers can make quick and accurate evaluations in critical situations.

Impact of Accurate Burn Assessment on Patient Outcomes

The precision of burn assessment using methods like the rule of nines has a significant impact on patient care and outcomes:

Optimized Fluid Resuscitation

Accurate TBSA estimation allows for precise calculation of fluid requirements, reducing the risk of under- or over-resuscitation, both of which can lead to complications.

Appropriate Triage

Correct assessment ensures patients are directed to the most appropriate level of care, whether that’s a specialized burn unit or a general hospital ward.

Tailored Nutritional Support

TBSA estimation helps in calculating the increased nutritional needs of burn patients, crucial for wound healing and recovery.

Wound Care Planning

Understanding the extent of burns guides decisions on wound care strategies, including the potential need for skin grafting or other advanced treatments.

Prognosis and Recovery Expectations

The extent of burns, as determined by methods like the rule of nines, helps in predicting recovery timelines and potential long-term outcomes, aiding in patient and family counseling.

By providing a quick and relatively accurate assessment of burn severity, the rule of nines plays a crucial role in initiating appropriate care promptly, potentially improving survival rates and long-term outcomes for burn patients.

Global Perspectives on Burn Assessment and Care

While the rule of nines is widely used globally, approaches to burn assessment and care can vary across different countries and healthcare systems:

Resource Variations

In low-resource settings, healthcare providers may rely more heavily on visual assessment methods like the rule of nines due to limited access to advanced imaging technologies.

Cultural Considerations

Some cultures may have specific considerations regarding burn care and body exposure during assessment, which healthcare providers must navigate sensitively.

International Collaborations

Global initiatives aim to standardize burn care practices, including assessment methods, to improve outcomes worldwide. These efforts often involve sharing best practices and training programs across borders.

Understanding these global perspectives is crucial for healthcare providers working in diverse settings or participating in international medical missions focused on burn care.

Future Directions in Burn Assessment and Care

As medical science advances, new frontiers in burn assessment and treatment are emerging:

Artificial Intelligence in Burn Assessment

Machine learning algorithms are being developed to analyze images of burns and provide rapid, accurate TBSA estimations, potentially enhancing the precision of methods like the rule of nines.

Personalized Treatment Protocols

Research is ongoing to develop more individualized approaches to burn care, taking into account factors like genetic predisposition to healing and individual metabolic responses to injury.

Advanced Wound Healing Technologies

Innovations in wound care, such as bioengineered skin substitutes and growth factor therapies, may influence how burn severity is assessed and treated in the future.

These advancements hold the promise of further improving outcomes for burn patients, potentially reducing mortality rates and enhancing quality of life for survivors.

In conclusion, the rule of nines remains a fundamental tool in burn assessment, providing a rapid and effective method for estimating burn severity. Its simplicity and reliability make it invaluable in emergency situations, guiding critical decisions in the early stages of burn care. As medical science progresses, this time-tested method continues to be refined and complemented by new technologies and approaches, ensuring that burn patients receive the most appropriate and effective care possible.

Burns, Children, Adults, Wallace, and More

Rule of Nines: Burns, Children, Adults, Wallace, and More

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Medically reviewed by Alana Biggers, M. D., MPH — By Rachel Nall, MSN, CRNA — Updated on July 20, 2018

What is the rule of nines?

The rule of nines is a method doctors and emergency medical providers use to easily calculate the treatment needs for a person who’s been burned.

It’s sometimes referred to as the Wallace rule of nines after Dr. Alexander Wallace, the surgeon who first published the method. The creation of this method is credited to Pulaski and Tennison.

A medical professional will do a visual examination to look for seriously burned areas and use the rule of nines to quickly add up what percentage of a person’s body is burned. While doctors will perform more thorough examinations for burn estimation, they can use the rule of nines to quickly assess a person and start recommending treatment centers and interventions to help a person.

The rule of nines is meant to be used for:

second-degree burns, also known as partial-thickness burns
third-degree burns, known as full-thickness burns

The rule of nines assigns a percentage that’s either nine or a multiple of nine to determine how much body surface area is damaged. For adults, the rule of nines is:

A medical provider can use calculations from the rule of nines in several ways. This includes the amount of fluid replacement and degree of care a person needs.

When a person experiences a second-degree burn or worse, the protective layer of skin is destroyed. As a result, they’ll lose a significant amount of body water. This makes providing fluids vital to helping a person maintain their total body water. According to the National Institutes of Health, burns that are greater than 20 to 25 percent of total body surface area require significant intravenous (IV) fluids. Doctors will also use the estimated body surface area burned to determine how much fluid to administer.

The rule of nines can also relay to a medical team receiving the patient how serious the injury is. Providers also know that burns that exceed 30 percent of a person’s body can be potentially fatal, according to the National Institutes of Health.

If a person has burns on 10 percent of their body surface area or greater, a specialized burn center should treat their wounds. Other circumstances where a burn center should treat the wounds include:

when the person is a child
when the burned areas involve key areas of the body, such as the hands, feet, genitalia, face, or major joints
chemical burns
electrical burns
the presence of third-degree burns

Another example of how a provider may use the rule of nines is to determine how much IV access is needed. If a person has 15 percent or more of their total body surface area burned, they’ll need at least one peripheral line to provide IV fluids. If a person’s body is burned 40 percent or more, they’ll need at least two IVs.

Doctors don’t typically use the same calculations in the rule of nines to children. This is because children tend to have different body proportions than adults do, including larger heads and smaller legs. For example, children tend to proportionally have a 20 percent larger head than adults, according to the National Institutes of Health. Infants also have 13 percent smaller legs than adults.

Therefore, there are a few adjustments for the rule of nines in children:

Burns are a serious, painful injury that require immediate treatment and intervention. The rule of nines serves as a quick method of assessment for a medical provider to estimate the extent of a person’s injuries. If the person with burns is a child, the rule of nines should be adjusted due to differences in a child’s proportions.

Last medically reviewed on July 19, 2018

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Assessing burns and planning resuscitation: The rule of nines. (n.d.).
uwhealth.org/emergency-room/assessing-burns-and-planning-resuscitation-the-rule-of-nines/12698
Burn triage and treatment – Thermal injuries. (2017).
chemm.nlm.nih.gov/burns.htm
Helttiaratchy S. (2004). Initial management of a major burn: II—assessment and resuscitation. DOI:
10.1136/bmj.329.7457.101
Lee KC, et al. (2014). History of burns: The past, present and the future. DOI:
10.4103/2321-3868.143620
Quick reference guide: Burn stabilization. (n.d.).
uwmedicine.org/airlift-nw/Documents/burn-pocket-card-final.pdf

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Medically reviewed by Alana Biggers, M.D., MPH — By Rachel Nall, MSN, CRNA — Updated on July 20, 2018

What is the rule of nines, and how can it be applied in burn care?

The rule of nines is a method used to estimate TBSA, inform fluid resuscitation and initiate the patient transfer process. For patient safety, the rule of nines should only be calculated by healthcare professionals.

For Burn and Reconstructive Centers of America (BRCA), burn centers across our care system, emergency services personnel and many other facilities, the rule of nines is the foundation of emergency and pre-burn center care. The rule of nines is a method used to estimate Total Body Surface Area (TBSA), or the percentage of the body surface burned. Healthcare professionals typically use the rule of nines upon patient intake before starting fluid resuscitation.

Upon intake of a new burn patient, healthcare professionals will assess the patient for severe trauma that needs to be addressed before the burns and stabilize the patient. If there are no other traumatic injuries that need to be prioritized, then the burn care team will begin to treat the burn injuries. One of the first steps in emergency burn care is using the rule of nines to estimate the TBSA. The rule of nines is not used for every burn patient. It is typically used for calculating the most severe burn injuries, such as second-, third- and fourth-degree burns. First-degree burns are considered minor burns and generally don’t require medical attention, hospital transfer or fluid resuscitation.

When calculating the TBSA, the burn team or emergency services will use the rule of nines body chart as a guide. This chart shows the percentage of each body part, front and back. Each part of the body is broken up into increments of 9%, hence the rule of nines. For example, each adult arm counts as 4.5% for the front and 4.5% for the back, accounting for 9% for each arm out of a total of 100% of the entire body. Each adult leg counts as 9% for the front and 9% for the back, totaling 18% for the whole of each leg, and so on. When the burns are spread out, or there are burned patches here and there, it is common practice to use the size of the patient’s palm to calculate those areas with the palm counting as 1%.

The adult rule of nines is broken down as follows:

Head (including neck): 4. 5% anterior (front) and 4.5% posterior (back) for a total of 9%
Each arm (including the hands): 4.5% anterior and 4.5% posterior for a total of 9% each
Torso: 9% anterior and 9% posterior for a total of 18%
Pelvis: 9% anterior and 9% posterior for a total of 18%
Genitalia: 1% anterior
Each leg (including feet): 9% anterior and 9% posterior for a total of 18% each

However, the adult rule of nines is not recommended for treating minors. For those pediatric patients, the rule of nines is adjusted for the proportional differences in the head, torso and legs.

The rule of nines for pediatric patients is broken down as follows:

Head (including neck): 9% anterior and 9% posterior for a total of 18%
Each arm (including the hands): 4.5% anterior and 4.5% posterior for a total of 9% each
Torso: 18% anterior and 18% posterior for a total of 36%
Each leg (including the feet): 7% anterior and 7% posterior for a total of 14% each

It’s important to note the distinctions between the adult and pediatric rule of nines. There are two main differences for children zero to nine years of age:

A child’s head is proportionally larger at birth and accounts for 18% of its body area. For each year over one year old, 1% should be subtracted from the head up to nine years old. The head of children ages ten and up should be calculated at 9%.
At the same time, 0.5% should be added to each leg for each year up to nine years old.

Once the TBSA has been calculated, the burn care team begins life-saving fluid resuscitation. Fluid resuscitation involves replacing or replenishing the body’s fluids lost during the burn injury using the preferred Lactated Ringers (LR) solution or Normal Saline if LR is not available. Fluid resuscitation aims to maintain blood circulation (perfusion) and organ function while avoiding inadequate or excessive fluid replacement. Proper fluid resuscitation is dependent on the accurate calculation of the patient’s TBSA. It’s crucial to accurately dose fluid, as an overloaded patient often experiences increased mortality and morbidity rates. Note, however, that not all burn patients need to be resuscitated. Burns under 10% TBSA do not require fluid resuscitation.

Using the rule of nines to estimate TBSA not only helps calculate proper fluid resuscitation but also sets the amount of intravenous (IV) access a burn patient needs (15% or more = at least one and 40% or more = at least two) and whether the patient needs to be transferred. The American Burn Association has established ten criteria for transferring a burn-injured patient for treatment. One of those ten criteria includes transferring those with partial-thickness burns with a ≥10% TBSA.

The move towards specialized burn care has enabled burn centers like those in BRCA’s system to research, implement and improve early resuscitation practices to avoid over-aggressive fluid treatment. If you have any doubts, please call a member of our burn team at 855-863-9595 or use our Burn App for quick provider-to-provider consultations. BRCA’s burn experts have treated tens of thousands of burn patients. They are available 24/7 to assist in ensuring the accuracy of fluid calculation and the general need for fluids.

More burn care resources for medical professionals can be found at burncenters.com or by clicking here.

Rules of Conduct in a Terrorist Attack – Public Safety Manuals

It is impossible to prepare for a terrorist attack in advance, so you should always be on your guard.

Rule of thumb: avoid unnecessarily visiting regions, cities, places and events that may attract the attention of terrorists.

General recommendations:

– pay attention to suspicious people, objects, any suspicious little things. Report anything suspicious to law enforcement;

– never accept packages and bags from strangers, do not leave your luggage unattended;

– the family must have a contingency plan, all family members must have phone numbers, email addresses.

– you need to designate a meeting place where you can meet your family members in an emergency;

– in case of evacuation, take a set of essential items and documents with you;

– always find out where the emergency exits from the premises are;

– in the house it is necessary to strengthen and seal the entrances to the basements and attics, install an intercom, clear the stairwells and corridors from cluttering objects;

– organize a duty of the residents of your house, who will regularly go around the building, observing that everything is in order, paying special attention to the appearance of unfamiliar faces and cars, unloading bags and boxes;

– if there was an explosion, fire, earthquake, never use the elevator;

– try not to panic, no matter what happens.

Crowd behavior:

Terrorists often choose to attack crowded places. In addition to the actual damaging factor of a terrorist act, people are killed and injured as a result of a stampede that arose as a result of panic. Therefore, it is necessary to remember the following rules of behavior in the crowd:

– Avoid large crowds.

– Do not join the crowd, no matter how much you want to see the events taking place.

– If you find yourself in a crowd, let it carry you, but try to get out of it.

– Inhale deeply and spread your arms bent at the elbows slightly to the sides so that the chest is not squeezed.

– Try to stay away from tall and large people, people with bulky objects and large bags.

– By all means try to stay on your feet.

– Keep your hands out of your pockets.

– While moving, raise your legs as high as possible, place your foot on a full foot, do not mince, do not rise on tiptoe.

– If the crush becomes threatening, immediately, without hesitation, get rid of any burden, especially a bag with a long strap and a scarf.

– If something is dropped, never bend down to pick it up.

– If you fall, try to get back on your feet as quickly as possible. At the same time, do not lean on your hands (they will be crushed or broken). Try to stand on your soles or on your toes at least for a moment. Having found support, “emerge”, sharply pushing off the ground with your feet.

– If you can’t get up, curl up in a ball, protect your head with your forearms, and cover the back of your head with your palms.

Once in a crowded room, determine in advance which places are the most dangerous in case of an emergency (passages between sectors in the stadium, glass doors and partitions in concert halls, etc.), pay attention to emergency and emergency exits, mentally do way to them.

The easiest way to hide from the crowd is in the corners of the hall or near the walls, but it is more difficult to get to the exit from there.

When panicking, try to remain calm and able to assess the situation soberly.

Do not join the protesters “for the sake of interest.” First, find out if the rally is sanctioned, what the speakers are campaigning for.

Do not join unregistered organizations. Participation in the activities of such organizations may result in criminal penalties.

During riots, try not to get into the crowd, both participants and spectators. You can fall under the actions of special forces soldiers.

When taken hostage:

Any person, by coincidence, can become a hostage of criminals. At the same time, they can achieve political goals, receive ransoms, etc. In all cases, your life becomes a bargaining chip for terrorists. Capture can occur in transport, in an institution, on the street, in an apartment. If you are taken hostage, we recommend that you adhere to the following rules of conduct:

– basic rule – do not allow actions that can provoke attackers to use weapons and lead to human casualties;

– endure deprivation, insults and humiliation. Do not look into the eyes of criminals, do not behave defiantly;

– if necessary, follow the requirements of criminals, do not contradict them, do not risk the lives of others and your own. Try to avoid tantrums and panic;

– to perform any action (sit down, get up, drink, go to the toilet), ask permission;

– if you are injured, try not to move, this will reduce blood loss.

Remember – your goal is to stay alive. Be careful, try to remember the signs of criminals, the distinctive features of their faces, clothes, names, nicknames, possible scars and tattoos, speech and behavioral features, conversation topics, etc. Remember that having received a message about your capture, the special services have already begun to act and will take all necessary actions to free you. During the operation by the special services to release you, strictly observe the following requirements:

– lie face down on the floor, cover your head with your hands and do not move;

– under no circumstances run towards or away from the secret services, as they may take you for a criminal;

– if possible, stay away from door and window openings.

You may find yourself in a situation where you become aware of an impending or committed crime, perhaps someone knows about an impending crime against you. As you lead, so, perhaps, others will behave.

In the event of a terrorist attack:

– Always be aware of the situation around you, especially when you are at transport facilities, cultural and entertainment, sports and shopping centers.

– If you find forgotten things, without touching them, notify the driver, employees of the facility, security service, police. Do not try to look inside a suspicious package, box, or other object.

– Do not pick up abandoned things, no matter how attractive they look.

– Explosive devices (in beer cans, cell phones, etc.) can be camouflaged in them. Do not kick objects on the ground outside.

– If the security forces and law enforcement agencies suddenly become more active, do not show curiosity, go in the other direction, but do not run, so that you will not be mistaken for the enemy.

– In the event of an explosion or shooting, immediately fall to the ground, preferably under cover (curb, market stall, car, etc.). For greater safety, cover your head with your hands.

– If you accidentally learn about an impending terrorist attack, immediately report it to law enforcement agencies.

If you become aware of an impending or committed crime, immediately report it to the FSB or the Ministry of Internal Affairs.

Article 13. The procedure for calculating the insurance period \ ConsultantPlus

Article 13. The procedure for calculating the insurance period

Prospects and risks of disputes in a court of general jurisdiction. Situations related to Art. 13

– The citizen does not agree with the refusal to early assign an old-age insurance pension due to work with difficult working conditions

– The citizen does not agree with the refusal to early assign an old-age insurance pension in connection with work in the regions of the Far North or areas equivalent to them

If the periods provided for in Articles 11 and 12 of this Federal Law coincide in time, one of such periods is taken into account when calculating the insurance period at the choice of the person who applied for the establishment of an insurance pension.

(as amended by Federal Law No. 419-FZ of November 4, 2022)

(see the text in the previous edition)

3. When calculating the insurance period, the periods of activity of persons who independently provide themselves with work, heads and members of peasant (farmer) households, members of family (tribal) communities of indigenous peoples of the North, Siberia and the Far East of the Russian Federation, engaged in traditional economic activities, periods work for individuals (a group of individuals) under contracts is included in the length of service provided that insurance premiums are paid to the Pension and Social Insurance Fund of the Russian Federation.

(as amended by Federal Laws No. 164-FZ of 27.06.2018, No. 237-FZ of 14.07.2022)

(see the text in the previous edition)

old-age insurance pension by citizens receiving a pension for long service or a disability pension in accordance with the Law of the Russian Federation of February 12, 1993 N 4468-1 “On pension provision for persons who have served in the military, service in the internal affairs bodies, the State Fire Service, authorities for the control of the circulation of narcotic drugs and psychotropic substances, institutions and bodies of the penitentiary system, the troops of the National Guard of the Russian Federation, the enforcement agencies of the Russian Federation, and their families”, the length of service does not include periods of service that preceded the appointment of a disability pension, or periods of service, work and (or) other activities taken into account when determining the amount of pension for long service in accordance with the said Law. In this case, all periods that were included in the length of service are considered to be taken into account, including periods that do not affect the amount of the seniority pension or disability pension, in accordance with the specified Law.

(as amended by Federal Laws No. 536-FZ of December 27, 2018, No. 328-FZ of October 1, 2019)

(see the text in the previous edition)

old-age insurance pension by cosmonaut citizens receiving a seniority pension or a disability pension in accordance with Federal Law No. 166-FZ of December 15, 2001 “On State Pension Provision in the Russian Federation”, periods of work are not included in the length of service ( service) and (or) other activities preceding the appointment of a disability pension, or periods of work (service) and other activities taken into account when determining the amount of a pension for long service in accordance with the specified Federal Law, unless otherwise established by an international treaty of the Russian Federation.

6. When calculating the insurance period, periods of work during the full navigational period on water transport and during the full season in organizations of seasonal industries determined by the Government of the Russian Federation are taken into account in such a way that the duration of the insurance period in the corresponding calendar year is a full year .

7. Persons who performed work in the corresponding calendar year under copyright order agreements, as well as authors of works who received payments and other remuneration in the corresponding calendar year under agreements on the alienation of the exclusive right to works of science, literature, art, publishing license agreements, license agreements on granting the right to use a work of science, literature, art, if the total amount of accrued insurance premiums to the Pension and Social Insurance Fund of the Russian Federation from payments and other remuneration received under these agreements during this calendar year amounted to at least a fixed amount of the insurance premium for mandatory pension insurance established by subparagraph 1 of paragraph 1 of Article 430 of the Tax Code of the Russian Federation (until December 31, 2022 inclusive), or at least 80. 1078 percent of the total fixed amount of insurance premiums established by paragraph 1.2 of Article 430 of the Tax Code of the Russian Federation (starting from 2023 years), the length of service includes a period equal to a full calendar year (from January 1 to December 31), in which insurance premiums to the Pension and Social Insurance Fund of the Russian Federation are accrued from payments and other remuneration under these contracts. In the event that the total amount of accrued insurance premiums during the calendar year for these persons is less than the fixed amount of the insurance premium, a period (in months) with a duration calculated in proportion to the accrued insurance premiums, but not less than one calendar month (30 days) is included in the insurance period . The period counted in the length of service in connection with the accrual of insurance premiums to the Pension and Social Insurance Fund of the Russian Federation from payments and other remuneration under these contracts, if there are periods of work and (or) other activities, other periods in the corresponding calendar year, is taken into account in such a way that the insurance period for the corresponding calendar year does not exceed one year (12 months).

(Part 7 as amended by Federal Law No. 237-FZ of July 14, 2022)

(see the text in the previous edition)

7.1. For individual entrepreneurs applying the special tax regime “Automated Simplified Taxation System”, the period of insurance experience is counted equal to the period of application of the special tax regime “Automated Simplified Taxation System” in the corresponding calendar year, if the total amount taken into account by the Pension and Social Insurance Fund of the Russian Federation in as insurance premiums, information about which is transferred by the tax authorities to the bodies of the Pension and Social Insurance Fund of the Russian Federation in accordance with Article 19of the Federal Law “On the Experiment to Establish a Special Tax Regime “Automated Simplified Taxation System”, for a given calendar year amounted to at least the fixed amount of insurance premiums for compulsory pension insurance, established by subparagraph 1 of paragraph 1 of Article 430 of the Tax Code of the Russian Federation (until December 31, 2022 year inclusive), or at least 80. 1078 percent of the total fixed amount of insurance premiums established by paragraph 1.2 of Article 430 of the Tax Code of the Russian Federation (starting from 2023), determined in proportion to the number of calendar months and days falling on the period of application of the special tax regime “Automated simplified taxation system”. If the total amount accounted for by the Pension and Social Insurance Fund of the Russian Federation as insurance premiums, information about which is transferred by the tax authorities to the bodies of the Pension and Social Insurance Fund of the Russian Federation in accordance with Article 19of the Federal Law “On Conducting an Experiment to Establish a Special Tax Regime “Automated Simplified Taxation System”, for a given calendar year amounted to less than the fixed amount of insurance premiums determined in accordance with this part, a period determined in proportion to insurance premiums, but not more than the duration of the period of application by an individual entrepreneur of the special tax regime “Automated Simplified Taxation System” in this calendar year. 0003

(Part 7.1 was introduced by Federal Law No. 18-FZ of February 25, 2022; as amended by Federal Law No. 237-FZ of July 14, 2022)

(see the text in the previous edition)

in order to determine the right to an insurance pension, periods of work and (or) other activities that took place before the date of entry into force of this Federal Law and were counted in the seniority when assigning a pension in accordance with the legislation in force during the period of work (activity) may be included to the specified length of service using the rules for calculating the relevant length of service provided for by the indicated legislation (including taking into account the preferential procedure for calculating the length of service), at the choice of the insured person.

Consultant Plus: note.

Art. 13 (as amended by the Federal Law of November 4, 2022 N 419-FZ) applies to legal relations that arose from February 24, 2022.

9. When calculating the insurance period of the persons specified in Part 1.

What are the rules of nine. Rule of Nines for Burns: A Comprehensive Guide to Assessing Burn Severity

Understanding the Rule of Nines: A Vital Tool in Burn Assessment

Origins of the Rule of Nines

Applying the Rule of Nines in Adult Burn Assessment

Clinical Significance of TBSA Calculations in Burn Management

Fluid Resuscitation

Severity Assessment

Specialized Care Requirements

Adapting the Rule of Nines for Pediatric Burn Assessment

Special Considerations in Burn Assessment and Management

Location of Burns

Type of Burns

Depth of Burns

Importance of Accurate Burn Assessment in Treatment Planning

IV Access Requirements

Fluid Replacement Calculations

Triage and Facility Selection

Limitations and Considerations of the Rule of Nines

Advancements in Burn Assessment Techniques

3D Imaging and Computer-Assisted Measurement

Telemedicine in Burn Assessment

Biomarkers and Laboratory Tests

Training and Education in Burn Assessment

Impact of Accurate Burn Assessment on Patient Outcomes

Optimized Fluid Resuscitation

Appropriate Triage

Tailored Nutritional Support

Wound Care Planning

Prognosis and Recovery Expectations

Global Perspectives on Burn Assessment and Care

Resource Variations

Cultural Considerations

International Collaborations

Future Directions in Burn Assessment and Care

Artificial Intelligence in Burn Assessment

Personalized Treatment Protocols

Advanced Wound Healing Technologies

Burns, Children, Adults, Wallace, and More

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