Major burn with inhalation injury — MCCQE Part 1 MCQ

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HardTraumaMajor burn with inhalation injuryMCCQE Part 1

An 80 kg adult has partial-thickness burns of the anterior trunk and both entire arms. The burn occurred 2 hours ago. Using the Parkland starting estimate of 4 mL/kg/%TBSA and no fluid given before arrival, what initial crystalloid rate is required over the next 6 hours?

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Correct answer: B — 960 mL/hour

By the adult rule of nines, the anterior trunk is 18% and both entire arms are 18%, for 36% TBSA. Parkland starting volume is 4 × 80 × 36 = 11,520 mL in 24 hours. Half, 5,760 mL, is due in the first 8 hours from the time of injury. Because 2 hours have elapsed without fluid, 5,760 mL must be given over the next 6 hours: 5,760 ÷ 6 = 960 mL/hour. The rate is then titrated to response and urine output.

Reference: https://emergencycarebc.ca/clinical_resource/clinical-summary/burns/; https://www.albertahealthservices.ca/assets/info/hp/trauma/if-hp-trauma-burn-management-guideline.pdf