A 30-year-old burn victim has 45% TBSA burns (mixed partial and full thickness). The Parkland formula is used for resuscitation. The nurse asks how much fluid to give in the second 8 hours. Which answer is correct?

• A One-half of the 24-hour calculated volume
• B The same volume as given in the first 8 hours
• C Colloid is added in the second 8 hours at 0.5 mL/kg/% TBSA
• D One-quarter of the 24-hour calculated volume ✓

Explanation

Parkland formula: Total fluid = 4 mL × weight (kg) × %TBSA in first 24 hours (Ringer's lactate). Half of the 24-hour volume is given in the first 8 hours from time of injury (not from hospital arrival), the remaining half is divided equally over the next 16 hours (i.e., one-quarter in the second 8 hours and one-quarter in the third 8 hours). In the second 8-hour period (hours 9-16), one-quarter of total 24-hour volume is infused. Colloid (FFP, albumin 5%) is added from 6-12 hours post-burn in the Brooke and modified Galveston formulas to reduce edema, but not in the classic Parkland protocol.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.