A 28-year-old burn patient sustains 40% TBSA deep partial- and full-thickness burns. Using the Parkland formula, the resuscitation volume for the first 24 hours is 4 mL × kg × %TBSA. The patient weighs 70 kg. Of the calculated total volume, what fraction is given in the first 8 hours from time of injury (not time of arrival)?

• A One-quarter in first 8 hours
• B One-third in first 8 hours
• C Half in first 8 hours ✓
• D Two-thirds in first 8 hours

Explanation

The Parkland (Baxter) formula: 4 mL × 70 kg × 40% TBSA = 11,200 mL of Ringer's lactate in the first 24 hours from time of injury. Half (5,600 mL) is given in the first 8 hours from TIME OF INJURY (not from hospital arrival — if delayed, the rate must be accelerated). The remaining half is given over the next 16 hours. Colloid (albumin) is typically added from 8–24 hours in some protocols. The first 8-hour timing from injury is a key examination point.

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

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Written and medically reviewed by the StethoPrep medical team.