A 25-year-old man sustains 40% total body surface area (TBSA) burns (all partial and full thickness). Using the Parkland formula, calculate the total fluid volume for the first 24 hours. Weight: 70 kg.

• A 7,000 mL Ringer's lactate
• B 14,000 mL Ringer's lactate
• C 11,200 mL Ringer's lactate ✓
• D 9,800 mL Ringer's lactate

Explanation

Parkland formula: 4 mL × weight (kg) × %TBSA burned = 4 × 70 × 40 = 11,200 mL Ringer's lactate in first 24 hours. Half (5,600 mL) is given in the first 8 hours from time of injury, and the remaining half in the next 16 hours. Urine output should be maintained at 0.5–1 mL/kg/hr as the endpoint. This formula excludes superficial (first-degree/epidermal) burns from TBSA calculation.

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

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