A patient presents with 35% TBSA full-thickness burns. Using the Parkland formula, calculate the crystalloid fluid requirement in the first 24 hours for a 70 kg adult (use 4 mL/kg/% TBSA Ringer's lactate). How much should be given in the first 8 hours?

• A 3,850 mL
• B 2,450 mL
• C 6,125 mL
• D 4,900 mL ✓

Explanation

Parkland formula: 4 mL × 70 kg × 35% TBSA = 9,800 mL over 24 hours. Half (4,900 mL) is given in the first 8 hours from the time of burn (not from hospital arrival), and the remaining half (4,900 mL) over the next 16 hours. If the patient presents 2 hours after the burn, the first 8-hour half must be delivered in the remaining 6 hours. 3,850 mL would be half of a 55 kg patient; 2,450 mL would be a quarter; 6,125 mL is three-quarters of 9,800 mL.

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

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