The Parkland formula for fluid resuscitation in burns calculates total fluid requirement in the first 24 hours. A 70 kg man sustains 40% TBSA burns. What is the correct fluid regimen using the Parkland formula, and how is it distributed?

• A 5,600 mL of normal saline: given uniformly over 24 hours
• B 11,200 mL of colloid solution: one-third in first 8 hours, two-thirds in next 16 hours
• C 11,200 mL of Ringer's lactate: half in first 8 hours from time of burn, half in next 16 hours ✓
• D 8,400 mL of Ringer's lactate: one-third in first 8 hours, remainder over 16 hours

Explanation

Parkland formula = 4 mL × weight (kg) × %TBSA = 4 × 70 × 40 = 11,200 mL of Ringer's lactate. Distribution: 50% in the first 8 hours from the TIME OF BURN (not from time of arrival — account for delay), and 50% in the subsequent 16 hours. Ringer's lactate is preferred as it closely matches extracellular fluid composition. Colloid is avoided in the first 24 hours as capillary leak allows it to extravasate. Urine output monitoring (target 0.5-1 mL/kg/hr) guides adjustment of the calculated rate.

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

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