BURNS: o Anterior = 18% (chest 9,

abdomen 9)
• focusing on the fluid loss o Posterior = 18%
➢ due to fluid shifting (from • Arms = 18%
intravascular/blood vessel
• Arm = 9%
(functional space) to the interstitial
o Anterior arm = 4.5%
space (non-functional space))
o Posterior arm = 4.5%
➢ example: edema, ascites, anasarca
or
(generalized edema)
o Upper arm = 4.5%
o Forearm = 4.5%
*Sensible losses - literal na nawala ang
• Legs = 36%
fluid (vomiting, diarrhea)
• Leg = 18%
*Insensible losses - hindi literal nawala
o Anterior leg = 9%
(burn)
o Posterior leg = 9%
• Perineum = 1%
***Burns → tissue injury → albumin
(protein) loss → decrease oncotic
2. INFANT
pressure (kumukuha ng water from
interstitial to blood vessels) → lead to • Head and neck = 18% (ante. 9, post. 9)
fluid shifting/ third spacing • Trunk = 36%
o Anterior = 18% (chest 9,
• priority: fluid replacement/ resuscitation abdomen 9)
o Posterior = 18%
• best fluid for burns → PLR (volume
expander – SHOCK; sodium • Arms = 18%
bicarbonate (alkaline) → METABOLIC • Arm = 9%
ACIDOSIS (can cause cardiac arrest)) o Anterior arm = 4.5%
o Posterior arm = 4.5%
***Burns → tissue injury → shifting of Or
electrolytes → HYPERKALEMIA (can o Upper arm = 4.5%
cause CA), HYPONATREMIA → o Forearm = 4.5%
METABOLIC ACIDOSIS • Legs = 28%
• Leg = 14%
PARKLAND FORMULA: o Anterior leg = 7%
o Posterior leg = 7%
• total mL to be replaced in the 1st 24 hrs
• Perineum = x
• TBSA
➢ Total body surface area X BW (kg) x
4mL
➢ 50% FIRST 8 hrs Example:
➢ 50% LAST 16 hrs 1. Lady Nagant, 200lbs, sustained different
• Example: degrees of burn. Superficial head and
1. Adult 100 lbs; TBSA 80%. Total in the neck, full thickness anterior trunk,
1st 8 hrs? forearms. Deep partial at anterior legs,
➢ 100 lbs/2.2lbs = 45.45 kg abdomen, and perineum. Total mL in the
➢ 45.45 kg x 80% x 4ml = 14,545 first 8hrs?
➢ 14,545/2 = 7,272 mL ➢ TBSA
RULE OF 9’s - Anterior trunk = 18
- Forearms = 9
1. ADULT - Anterior legs = 18
• Head and neck = 9% (ante. 4.5, post. - Perineum = 1
4.5) - TOTAL: 46%
• Trunk = 36%
 ➢ 200 lbs/2.2 lbs = 90.90 kg
➢ Solution:
- 90.90 kg x 46% x 4 ml = 16, 725.6
(1st 24 hrs)
➢ 1st 8 hrs (50%) = 8,362mL
2. 6 mos. old, 30lbs. sustained deep partial
burn at legs, perineum, superficial burn
at post trunk. Full thickness burn at right
anterior arm and chest. Total mL in 1st
24hrs?
➢ TBSA:
- Legs = 28
- Right anterior arm = 4.5
- Chest = 9
- TOTAL: 41.5
➢ 30lbs/2.2lbs = 13.63 kg
➢ Solution:
- 13.63kg x 41.5% x 4mL = 2,262mL
(1st 24 hrs)
3. 30 years old, 200lbs, full thickness burn
at trunk, perineum. Deep partial burn at
chest and right forearm. Superficial at
head and neck. Total mL in the last
16hrs?
➢ TBSA:
- trunk = 36%
- perineum = 1%
- right forearm = 4.5%
- TOTAL: 41.5
➢ 200lbs/2.2lbs = 90.90 kg
➢ Solution:
- 90.90 kg x 41.5% x 4mL =
15,089mL (1st 24hrs)
- Last 16 hrs (50%) = 7, 544 mL
4. Infant 4kgs. Deep partial burn head and
neck left anterior leg. Full thickness
burns at right arm and left post arm.
Total mL in the 1st 8hrs?
➢ TBSA:
- Head and neck = 18
- Left anterior leg = 7
- Right arm = 9
- Left posterior arm = 4.5
- TOTAL: 38.5
➢ Solution:
- 4kgs x 38.5% x 4mL = 616mL (1st
24hrs)
- 1st 8 hrs (50%) = 308mL