What is the initial IV/IO fluid rate for burn victims with TBSA 25% and weight between 40 and 80 kg?

• A. 150 ml/hr
• B. 200 ml/hr
• C. 300 ml/hr
• D. 250 ml/hr

Answer: (D)

The right approach is using the Parkland formula for burn resuscitation: give 4 ml × body weight in kg × %TBSA burned of Lactated Ringer’s in the first 24 hours, with half of that volume given in the first 8 hours post-burn and the remaining half over the next 16 hours. For a 25% burn, the total 24-hour volume is 4 × weight × 25 = 100 × weight ml. Half of that in the first 8 hours equals 50 × weight ml, so the initial hourly rate is (50 × weight) / 8 = 6.25 × weight ml/hr. Within the weight range of 40–80 kg, this rate ranges from 250 ml/hr (for 40 kg) up to 500 ml/hr (for 80 kg). The option 250 ml/hr corresponds to the lower end of that range, which is why it’s chosen as the initial rate in this scenario. In practice, the rate is adjusted based on the patient’s actual weight within that range.