A 40 year woman was brought to the casualty 8 hours after sustaining burns on the abdomen, both the limbs and back. What will be the best formula to calculate amount of fluid to be replenished?
2 mL/kg x %TBSA
4 mL/kg x %TBSA
8 mL/kg x %TBSA
4 mL/kg x %TBSA in first 8 hours followed by 2 mL/ kg/hour x %TBSA
Answer- A. 2 mL/kg x %TBSAFluid resuscitation in burns:According to ATLS 10th edition, 2018, the resuscitation formula used in thermal burns is 2 mL/kg x % TBSA.First 8 hours: 1 mL/kg x % TBSA (lactated Ringer solution)Next 16 hours: 1 mL/kg x % TBSA (lactated Ringer solution)For a patient presenting 8 hours after sustaining thermal burns, the total volume using resuscitation formula should be given in the next 16 hours i.e; 2 mL/kg x % TBSA in the next 16 hours while maintaining target urine output of 0.5 mL/kg/hr for adults.In adults, urine output should be maintained between 30 and 50 cc/hr to minimize potential over-resuscitation.The total percentage of the burnt area is calculated clinically using the rule of nines. Burns - Formulae for Fluid Calculation(Updated according to ATLS 10th edition 2018 guidelines)