Question 2 of 16

You are evaluating a 70-kg woman who suffered 55% total body surface area second-degree burn in a kitchen fire. She arrives within less than 20 minutes after the injury occurred. Using the Parkland formula, you calculate the estimated total fluid requirements for the next 24 hours and the type and rate of fluid administration (round to the nearest 10 mL) to be:

Ringer lactate, 960 mL/h in the first 8 hours, then 480 mL/h for the next 16 hours.

Ringer lactate, 640 mL/h for the next 24 hours.

Normal saline, 480 mL/h in the first 8 hours, then 960 mL/h for the next 16 hours.

Normal saline, 540 mL/h for the next 24 hours.

None of the above.

Several formulas for fluid replacement in burns are available. The Parkland formula calls for 4 mL of lactated Ringer solution to be given per kilogram of body weight times the percentage burn. Half of this amount is given in the first 8 hours and the rest given over the next 16 hours. Thus, 4 × 70 × 55 = 15,400 mL/24 h. In the first 8 hours after the burn, 7700 mL is given at approximately 960 mL/h, and the remainder over the next 16 hours at approximately 480 mL/h. An important gauge of fluid replacement is the urine output, and the rate of fluid administration should be modified to maintain a urine output of 30–50 mL/h in adults, and 1 mL/kg/h in children.