According to Parkland formula, how is the initial fluid distributed?

• A. All fluids in first 8 hours
• B. A quarter in first 4 hours, rest later
• C. All fluids over 24 hours
• D. Half in the first 8 hours, the remainder over the next 16 hours

Answer: (D)

The Parkland formula guides burn resuscitation by splitting the total fluid over the first 24 hours: half of the calculated volume is given in the first 8 hours from the time of burn, and the remaining half over the next 16 hours. The total volume for the first 24 hours is 4 mL × body weight (kg) × %TBSA burned, typically using Lactated Ringer's solution. This means the correct distribution is half in the first 8 hours and the remainder in the next 16 hours. For example, a 70 kg patient with 30% TBSA burns would receive 8400 mL in 24 hours, with 4200 mL in the first 8 hours and 4200 mL over the subsequent 16 hours. The initial rate will be high for the first 8 hours and then taper as time progresses.