A 25-year-old man weighing 50 kg sustains flame burns involving his entire anterior trunk and both entire upper limbs. Using the Parkland formula, what is the total volume and type of fluid he should receive in the first 24 hours from the time of injury?

• A 3 litres of normal saline
• B 6 litres of Ringer lactate ✓
• C 6 litres of normal saline
• D 9 litres of Ringer lactate

Explanation

The Parkland formula gives 4 mL of Ringer lactate per kilogram per percent body surface area burned in the first 24 hours. Here, 4 × 50 × 30% = 6000 mL, that is 6 litres of Ringer lactate, with half given in the first 8 hours from the time of injury. Normal saline is not the recommended crystalloid because its chloride load predisposes to hyperchloraemic acidosis. The calculation starts from the time of injury, not from arrival at hospital.

Reference: Sabiston Textbook of Surgery, 21st ed.

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