A 70 kg patient comes to the emergency department with a 40% TBSA burn injury. According to the Parkland formula, what will be the expected fluid to be given in the first 8 hours to this patient?

1. A

   5800 ml

2. B

   11200 ml

3. C

   5600 ml

4. D

   6000 ml

Appeared in: NORCET 8 Prelims-2025

Explanation

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• The Parkland formula calculates the total 24-hour fluid requirement for a burn patient as 4 mL × Body Weight (kg) × % TBSA.
• For a 70 kg patient with a 40% TBSA burn, the total 24-hour fluid is 4 mL × 70 kg × 40 = 11,200 mL.
• The formula specifies that half of this total volume must be administered within the first 8 hours following the burn injury.
• Therefore, the fluid volume for the first 8 hours is 11,200 mL / 2 = 5,600 mL.

Why Other Options Were Wrong

• Option A: This is an incorrect calculation. It does not correspond to the result obtained from the standard Parkland formula.
• Option B: This value represents the total fluid volume to be administered over the entire 24-hour period, not just the first 8 hours.
• Option D: This is an incorrect calculation. It may result from a mathematical error or using an incorrect constant in the formula.

Related Visual

Clinical Relevance

• Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Fluid resuscitation calculation for burn patients using the Parkland formula in acute care settings.
• Accurate fluid resuscitation is critical to prevent hypovolemic shock (burn shock) in patients with major burns, which can lead to organ failure and death.
• Nurses are responsible for calculating, initiating, and titrating the fluid infusion based on the patient's response, primarily by monitoring hourly urine output.
• The 8-hour resuscitation clock starts at the time of the burn, not hospital arrival. This is a crucial patient safety point; delays require faster infusion rates to 'catch up'.

How to Approach the Question

• This is an analytical/calculation question. First, identify the specific formula required by the question, which is the Parkland formula.
• Extract all the necessary variables from the question stem: Body Weight (70 kg) and % TBSA (40%).
• Substitute these values into the formula (4 mL × kg × %TBSA) to calculate the total fluid volume for 24 hours.
• Carefully read the question again to determine the specific time frame for which the fluid volume is being asked (the first 8 hours).
• Apply the administration rule for that time frame (divide the 24-hour total by 2 for the first 8 hours).
• Compare your final calculated answer to the given options to find the correct choice.

Concept Tested & Keywords

• Concept Tested: Fluid resuscitation calculation for burn patients using the Parkland formula.
• Stem keywords: 70 kg, 40% TBSA, burn injury, Parkland formula, first 8 hours
• Lead-in keywords: what will be the expected fluid
• Clinical cues: The question asks for the fluid volume in the 'first 8 hours', which is a key component of the Parkland formula's administration schedule.

Question ID

QtQM1PxNtfuR_9Lk32MHSQ

Copy ID

Reference Book

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 694-696

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 748-750