Initial burn resuscitation uses intravenous isotonic crystalloids.

Initial burn resuscitation uses intravenous isotonic crystalloids.

• A. IV isotonic crystalloids
• B. Oral rehydration solutions
• C. Colloids only
• D. No fluids

Answer: (A)

Restoring circulating volume after a major burn is essential because the injury triggers capillary leak and substantial fluid shifts that can lead to hypovolemia. The best initial resuscitation fluid is an intravenous isotonic crystalloid, such as lactated Ringer's solution, because it expands the extracellular space and rapidly improves intravascular volume without causing osmotic imbalances that could worsen edema. In practice, this approach is guided by resuscitation protocols that allocate about half of the calculated fluid in the first 8 hours from the time of burn and the remainder over the next 16 hours, with adjustments based on urine output to ensure perfusion (adult targets roughly 0.5–1 mL/kg/hour). Oral rehydration solutions are not suitable for immediate resuscitation due to intake and absorption limitations and ongoing losses; colloids are not first-line in the initial period, though they may be used later if crystalloids alone do not maintain perfusion. No fluids would leave the patient incompletely resuscitated and at ongoing risk.

Restoring circulating volume after a major burn is essential because the injury triggers capillary leak and substantial fluid shifts that can lead to hypovolemia. The best initial resuscitation fluid is an intravenous isotonic crystalloid, such as lactated Ringer's solution, because it expands the extracellular space and rapidly improves intravascular volume without causing osmotic imbalances that could worsen edema. In practice, this approach is guided by resuscitation protocols that allocate about half of the calculated fluid in the first 8 hours from the time of burn and the remainder over the next 16 hours, with adjustments based on urine output to ensure perfusion (adult targets roughly 0.5–1 mL/kg/hour). Oral rehydration solutions are not suitable for immediate resuscitation due to intake and absorption limitations and ongoing losses; colloids are not first-line in the initial period, though they may be used later if crystalloids alone do not maintain perfusion. No fluids would leave the patient incompletely resuscitated and at ongoing risk.