A 35-year-old man sustains 35% total body surface area burns (20% deep partial thickness, 15% full thickness) in a house fire. He weighs 70 kg. Using the Parkland formula for fluid resuscitation in the first 24 hours, the total crystalloid requirement and the volume to be given in the first 8 hours from the time of burn (not from hospital arrival) is:

• A Total 7,000 mL; first 8 hours: 3,500 mL
• B Total 9,800 mL; first 8 hours: 2,450 mL
• C Total 9,800 mL; first 8 hours: 4,900 mL ✓
• D Total 4,900 mL; first 8 hours: 2,450 mL

Explanation

Parkland formula: 4 mL × weight (kg) × % TBSA burned = total volume in first 24 hours. Only burns >20% and specifically deep partial-thickness and full-thickness burns are included; superficial burns are excluded. Total = 4 × 70 × 35 = 9,800 mL of Lactated Ringer's. Half (4,900 mL) is given in the first 8 hours from the TIME OF BURN (not hospital arrival), and the remaining half over the next 16 hours. Time of burn is critical — prehospital time must be subtracted from the 8-hour window, meaning the infusion rate may need to be adjusted upward on hospital arrival.

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

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Written and medically reviewed by the StethoPrep medical team.