A burn patient weighs 220 lbs and has a TBSA of 30% . What is the initial IV resuscitation rate ?

A burn patient weighs 220 lbs and has a TBSA of 30% . What is the initial IV resuscitation rate ?

• A. 200 mL/hr
• B. 500 mL/hr
• C. 750 mL/hr
• D. 1000 mL/hr

Answer: (B)

Parkland formula is used to guide burn resuscitation with Lactated Ringer’s. You multiply 4 mL by the patient’s weight in kilograms and by the percent of total body surface area burned to get the total fluid in the first 24 hours. For this patient, 220 lb is about 100 kg, and the TBSA is 30%, so the total fluid over 24 hours would be 4 × 100 × 30 = 12,000 mL. Half of that, 6,000 mL, should be given in the first 8 hours after injury. That translates to 6,000 mL ÷ 8 hours = 750 mL per hour as the initial resuscitation rate. So start at roughly 750 mL/hour and reassess—urine output and vital signs guide subsequent adjustments, with the goal of a reasonable urine output (about 0.5 mL/kg/hr in adults). The option of 500 mL/hour would deliver only about 4,000 mL in the first 8 hours, which under-resuscitates compared with Parkland.

Parkland formula is used to guide burn resuscitation with Lactated Ringer’s. You multiply 4 mL by the patient’s weight in kilograms and by the percent of total body surface area burned to get the total fluid in the first 24 hours. For this patient, 220 lb is about 100 kg, and the TBSA is 30%, so the total fluid over 24 hours would be 4 × 100 × 30 = 12,000 mL. Half of that, 6,000 mL, should be given in the first 8 hours after injury. That translates to 6,000 mL ÷ 8 hours = 750 mL per hour as the initial resuscitation rate.

So start at roughly 750 mL/hour and reassess—urine output and vital signs guide subsequent adjustments, with the goal of a reasonable urine output (about 0.5 mL/kg/hr in adults). The option of 500 mL/hour would deliver only about 4,000 mL in the first 8 hours, which under-resuscitates compared with Parkland.