Question

An adult patient has come into the burn unit during your shift. You take an inventory of the location of their burns in the chart below.

Part of Body Burned?
(1 = yes, 0 = no)
Head 1
Left Arm 1
Right Arm 1
Upper Front Torso 1
Upper Back Torso 1
Lower Front Torso 1
Lower Back Torso 0
Upper Left Leg 1
Upper Right Leg 0
Lower Left Leg 0
Lower Right Leg 0


Given that their weight/mass is 91.1 kg, determine how much fluid they should receive per hour in the first 8 hours of their care. Answer to the nearest hundredth of a liter (two decimal places).

Answer 1

To calculate the fluid requirement for a burn patient in the first 8 hours, use the Parkland formula. For this patient with a TBSA of 54% and a weight of 91.1 kg, the fluid requirement is 4 mL/kg/% TBSA, totaling 19674.8 mL for the first 24 hours, half of which is given in the first 8 hours. The resulting fluid administration rate is approximately 1.23 liters per hour for the first 8 hours.

Step-by-step explanation:

The question involves calculating the fluid administration rate for an adult patient with burns over various parts of their body. To determine the amount of fluid the patient should receive in the first 8 hours of care, we use the Parkland formula, which is a standard medical formula used to calculate fluid needs for burn patients.

The Parkland formula states that the patient should receive 4 mL of fluid for every kilogram of body weight for every percent of total body surface area (TBSA) burned in the first 24 hours after the burn, with half given in the first 8 hours.

First, we calculate the TBSA burned using the 'rule of nines,' which gives specific percentage values to different body parts.

According to the 'rule of nines,' the body is divided into sections that are multiples of nine. The head and neck account for 9%, each arm for 9%, the front of the torso for 18% (9% upper and 9% lower), the back of the torso for 18% (9% upper and 9% lower), each leg for 18% (9% upper and 9% lower), and the genital area for 1%. Based on the provided chart:

• Head: 9%
• Left Arm: 9%
• Right Arm: 9%
• Upper Front Torso: 9%
• Upper Back Torso: 9%
• Lower Front Torso: 9%
• Upper Left Leg: 9%

Adding these up gives us a total TBSA of 54%. Now we use the Parkland formula:

Fluid requirement = 4 mL × 91.1 kg × 54%

We first calculate for the first 24 hours:

Fluid requirement = 4 mL/kg × 91.1 kg × 54

Fluid requirement = 19674.8 mL

The patient should receive half of this amount in the first 8 hours:

Fluid in first 8 hours = 19674.8 mL / 2

Fluid in first 8 hours = 9837.4 mL

We convert this to liters, knowing that there are 1000 milliliters in a liter:

Fluid in first 8 hours = 9837.4 mL / 1000

Fluid in first 8 hours = 9.84 liters

This is the total fluid for 8 hours, so per hour the patient should receive:

Fluid per hour = 9.84 L / 8

Fluid per hour = 1.23 L

To the nearest hundredth, the patient should receive 1.23 liters of fluid per hour for the first 8 hours of their care.