What is The Fluid Resuscitation Protocol?
Severe burns trigger rapid, massive fluid shifts resulting in systemic hypovolemic shock. Administering Ringer's lactate IV fluid is critical to prevent circulatory collapse. The Parkland Formula calculates the precise 24-hour baseline.
Mathematical Foundation
= Total 24-Hour IV Fluid Volume (mL). Usually Ringer's Lactate.
= Patient Weight (kilograms).
= Total Body Surface Area burned (percentage).
Laws & Principles
- Phase 1 (The First 8 Hours): 50% of the total 24-hour calculated volume MUST be given in the first 8 hours post-injury, when fluid shifting is most aggressive and volatile.
- Phase 2 (The Next 16 Hours): The remaining 50% is steadily dripped over the trailing 16 hours.
- The Time Zero Anchor: Time starts from the exact moment the burn occurred, NOT the time of hospital admission. To compensate for transport time, the Phase 1 rate must often be increased.
Step-by-Step Example Walkthrough
" A 75kg patient arrives with 20% TBSA burns. The burn occurred exactly 1 hour ago. We must calculate the Parkland resuscitation rates. "
- 1. Calculate Total Volume: 4mL * 75kg * 20% = 6,000 mL.
- 2. Calculate Phase 1 Volume: 6,000 / 2 = 3,000 mL total.
- 3. Calculate Phase 1 Rate for remaining time: Since 1 hour has elapsed, we have 7 hours left for Phase 1. 3,000 mL / 7 hours = 428 mL/hr.
- 4. Calculate Phase 2 Rate: 3,000 mL / 16 hours = 187.5 mL/hr.
Final Result: The patient needs 6 Liters of Ringer's Lactate total. You must aggressively infuse it at 428 mL/hr for the next 7 hours to catch up, then drop the IV rate to 188 mL/hr for the remaining 16 hours.