A 30-year-old patient sustains 60% TBSA deep burns. The Parkland formula calculates Ringer's Lactate requirement in the first 24 hours as 4 mL × kg × % TBSA. For a 70-kg patient with 60% TBSA burns, how much fluid should be administered in the first 8 hours?
- A 4200 mL
- B 8400 mL ✓
- C 16800 mL
- D 5600 mL
Correct answer: B. 8400 mL
Explanation
Parkland formula: 4 mL × 70 kg × 60% TBSA = 16,800 mL total in 24 hours. Half of this (8,400 mL) is given in the first 8 hours from the time of injury (not from admission), and the remaining half (8,400 mL) over the next 16 hours. If the patient arrives 2 hours post-injury, the first 8-hour portion must be administered in the remaining 6 hours. Burns to face, genitalia, hands, and feet are excluded from TBSA calculation for resuscitation purposes but influence mortality and functional outcome.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.