Burn Management: Fluid Resuscitation Calculations

Burn Patient Management

• The Parkland Formula is used to calculate fluid requirements for burn patients in the first 24 hours after injury.
• The formula is: Total Fluid Requirement (mL) = 4 × Body Weight (kg) × % TBSA burned.
• 50% of the total fluid requirement is given in the first 8 hours, and the remaining 50% is given over the next 16 hours.

Modified Brooke Formula

• The Modified Brooke Formula is an alternative to the Parkland Formula with slightly different fluid requirements.
• The formula is: Total Fluid Requirement (mL) = 2 × Body Weight (kg) × % TBSA burned.
• The administration of fluids is the same as the Parkland Formula: 50% in the first 8 hours, and 50% in the next 16 hours.

Urine Output Monitoring

• Urine output is used as a guide to adjust fluid resuscitation.
• The target urine output is 0.5 mL/kg/hr for adults and 1 mL/kg/hr for children.

Rule of Nines for Estimating TBSA

• The Rule of Nines is used to estimate the total body surface area (TBSA) affected by burns in adults.
• The areas and their corresponding percentages are:
  • Head and Neck: 9%
  • Each Arm: 9% (total for both arms = 18%)
  • Each Leg: 18% (total for both legs = 36%)
  • Anterior Trunk: 18%
  • Posterior Trunk: 18%
  • Perineum: 1%

Maintenance Fluid Calculation for Pediatric Patients

• In addition to resuscitation fluids, children may need maintenance fluids calculated based on their body weight.
• The formula for daily maintenance fluid is: 100 mL/kg for the first 10 kg + 50 mL/kg for the next 10 kg + 20 mL/kg for each additional kg.
• The formula for hourly maintenance fluid is: 4 mL/kg for the first 10 kg + 2 mL/kg for the next 10 kg + 1 mL/kg for each additional kg.