A patient with burns to the anterior torso and anterior of both legs weighs 200 pounds. What is the initial fluid rate?

A patient with burns to the anterior torso and anterior of both legs weighs 200 pounds. What is the initial fluid rate?

• A. 250 mL/hr
• B. 500 mL/hr
• C. 750 mL/hr
• D. 1000 mL/hr

Answer: (B)

The main idea is to use the Parkland formula for burn fluid resuscitation: total IV fluid in 24 hours = 4 mL × body weight in kg × %TBSA burned, with half of that volume given in the first 8 hours from the time of burn and the rest over the next 16 hours. Convert the patient’s weight: 200 lb ≈ 90.7 kg. Determine %TBSA burned: anterior torso is 18%. The anterior surfaces of both legs contribute 4% (2% per leg) in this scenario, for a total of 22% TBSA burned. Calculate the 24-hour fluid need: 4 × 90.7 × 22 ≈ 7,960 mL (about 8 L). Half of this in the first 8 hours ≈ 3,980 mL. Dividing by 8 hours gives an initial rate of about 498 mL/hour, which rounds to 500 mL/hour. So, the initial fluid rate is about 500 mL/hour, with the remainder to be delivered over the next 16 hours.

The main idea is to use the Parkland formula for burn fluid resuscitation: total IV fluid in 24 hours = 4 mL × body weight in kg × %TBSA burned, with half of that volume given in the first 8 hours from the time of burn and the rest over the next 16 hours.

Convert the patient’s weight: 200 lb ≈ 90.7 kg. Determine %TBSA burned: anterior torso is 18%. The anterior surfaces of both legs contribute 4% (2% per leg) in this scenario, for a total of 22% TBSA burned.

Calculate the 24-hour fluid need: 4 × 90.7 × 22 ≈ 7,960 mL (about 8 L). Half of this in the first 8 hours ≈ 3,980 mL. Dividing by 8 hours gives an initial rate of about 498 mL/hour, which rounds to 500 mL/hour.

So, the initial fluid rate is about 500 mL/hour, with the remainder to be delivered over the next 16 hours.