According to the Parkland formula, how should fluids be distributed in the first 24 hours?

• A. All fluids in 24 hours
• B. Quarter in first 8 hours, rest in next 16 hours
• C. All fluids in first 8 hours
• D. Half in the first 8 hours, remaining in next 16 hours

Answer: (D)

Parkland formula guides burn resuscitation by calculating a total fluid need for the first 24 hours: total fluids = 4 mL × body weight in kg × %TBSA burned, commonly using lactated Ringer's solution. Half of that volume is given in the first eight hours from the time of burn, and the remaining half over the next 16 hours. This timing targets the early shock window from capillary leak and intravascular volume loss, providing rapid repletion initially while avoiding fluid overload later. Giving all fluids in 24 hours wouldn’t address the critical early needs, and delivering everything in the first eight hours would risk over-resuscitation; distributing only a quarter in the first eight hours would under-resuscitate early.