50% partial thickness burn (83/1700)

A 34yo pt presents with 50% partial thickness burns. What should be the most appropriate
management?

a. IV fluids calculated from the time of hospital arrival
b. IV fluids calculated from the time of burn
c. No IVF
d. IV dextrose stat
e. Burns ointment






























answer: B

The Parkland formula(used in burns >30%) is now the most accepted way of estimating the volume of fluid to be given in the first 24 hours. Half the volume should be given in the first 8 hours; the remainder over the next 16 hours.

4mL x weight (kg) x % burn area = Fluid replacement (mL) in first 24 hours from sustaining the burn

For example, a 70 kg patient with a 40% burn would, using this formula, require a figure of :

4 × 70 × 40 = 11200 mL.

Half of this (5600 mL) is given in the first 8 hours and the other half in the next 16 hours. This does not include the daily maintenance fluid requirement (3 litres in an adult).

Type of fluid used for replacement. Ringer’s lactate (Hartmann’s solution) is the crystalloid of choice for the first 24 hours. This has been shown to cause less pulmonary oedema than colloid.