Using the Parkland formula for burns resuscitation, a 70 kg adult with 40% TBSA burns should receive how much Hartmann's solution in the first 8 hours from the time of injury (not hospital arrival)?

• A 2800 mL
• B 5600 mL
• C 3 × 70 × 40 = 8,400 mL total; half = 4,200 mL in first 8 hours
• D 4 × 70 × 40 = 11,200 mL total; half = 5,600 mL in first 8 hours from time of burn ✓

Explanation

The Parkland formula: 4 mL × weight (kg) × %TBSA = total volume for first 24 hours (Hartmann's/Ringer's lactate). Half is given in the first 8 hours and half in the next 16 hours, calculated from the time of burn injury, not hospital arrival. For a 70 kg patient with 40% TBSA: 4 × 70 × 40 = 11,200 mL total; 5,600 mL in the first 8 hours. If fluid is commenced 4 hours post-burn, the entire first-half volume must be administered in the remaining 4 hours. Urine output of 0.5 mL/kg/hr is the primary resuscitation endpoint.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.