A patient with 40% TBSA burns from flame (mixed superficial and deep partial thickness). According to the Parkland formula, calculate the volume of Ringer's lactate required in the first 24 hours for a 70 kg patient:

• A 2 mL × 70 kg × 40 = 5,600 mL; all given evenly over 24 hours
• B 4 mL × 70 kg × 40 = 11,200 mL; one-third in first 8 hours, two-thirds in next 16 hours
• C 4 mL × 70 kg × 40 = 11,200 mL; half (5,600 mL) in first 8 hours from time of burn, half in next 16 hours ✓
• D 3 mL × 70 kg × 40 = 8,400 mL; half in first 8 hours, half over next 16 hours

Explanation

The Parkland (Baxter) formula is 4 mL × weight (kg) × % TBSA burned (second- and third-degree burns) of Ringer's lactate in 24 hours. Half is given in the first 8 hours from the time of burn (not from hospital arrival), and the remaining half over the next 16 hours. For this patient: 4 × 70 × 40 = 11,200 mL total; 5,600 mL in first 8 hours, 5,600 mL over next 16 hours. Adequacy is monitored by urine output (target 0.5-1 mL/kg/hr in adults). Superficial burns and head/face burns do not require fluid resuscitation by the Parkland formula.

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

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Written and medically reviewed by the StethoPrep medical team.