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Fluid Resuscitation

Step 1

Place 2 large bore IV's

  • Attempt in nonburn extremity (may place through burned skin if necessary)

Step 2

Calculate body surface area burned

Tip: To estimate scattered burns: patient's palm surface = 1% total body surface area

Step 3

Calculate fluid resuscitation

  • Adults
    • Age >15 years
    • Ringers Lactate 2-4cc X kilogram body weight X percent burn.
  • Infants and children
    • Ringers Lactate 3-4cc X kilogram body weight X percent burn.
  • For infants < 4 years old add maintenance fluid of D5LR
    • For the 1st 10 Kg of body weight: 100cc/Kg/ 24 hrs
    • For the 2nd 10 Kg of body weight: 50cc/Kg/24 hrs
    • For each Kg of body weight above 20 Kg: 20cc/Kg/24 hrs

Tip: Monitor glucose for infants and young children

Step 4

Administer fluid

  • Infuse 1/2 estimated resuscitation volume over first 8 hrs
  • Infuse 1/2 estimated resuscitation over next 16 hrs

Tip: Fluid resuscitation begins at time of injury

Step 5

Monitor urine output

Insert foley and titrate IV fluid to goal of:

  • Adults: 30-50cc/hour
  • Children: 1cc/Kg/hour