A patient with severe burns over 40% BSA develops hypovolaemic shock. If 4 mL/kg/% BSA burned of normal saline is infused (Parkland formula), what volume would be given in the first 8 hours for a 75 kg patient?

• A 12,000 mL total over 24 h; 6,000 mL in first 8 h ✓
• B 6,000 mL
• C 4,000 mL in first 8 h
• D 3,000 mL in first 8 h

Explanation

The Parkland formula calculates total 24-hour crystalloid as 4 mL × kg × % BSA burned. For this patient: 4 × 75 × 40 = 12,000 mL total over 24 hours. By protocol, half is given in the first 8 hours (6,000 mL) and the other half over the next 16 hours (3,000 mL in each 8-hour block). The rationale is that capillary leak is greatest in the first 8 hours post-burn, necessitating faster replacement.

Reference: Guyton & Hall, Textbook of Medical Physiology, 14th ed.

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