The Parkland Formula for Fluid Resuscitation

Full Answer Section

Pain Management

• Drug of Choice: Intravenous opioids (e.g., morphine, fentanyl) are the preferred method for pain relief in burn patients.
• Administration: Titrate the dose to achieve adequate pain control while monitoring for respiratory depression. Non-pharmacological interventions, such as relaxation techniques and distraction, may also be helpful.

Nutritional Requirements

• Hypermetabolic State: Burn patients experience a significant increase in metabolic rate, leading to increased caloric needs.
• Protein Intake: Adequate protein intake is essential for wound healing and tissue repair.
• Early Enteral Feeding: Early initiation of enteral feeding is recommended to prevent complications such as gastrointestinal atrophy and bacterial translocation.

Infection Prevention

• Aseptic Technique: Strict adherence to aseptic technique during wound care and dressing changes.
• Frequent Wound Cleansing: Gentle cleansing of wounds with mild soap and water or specialized wound cleansers.
• Antimicrobial Therapy: Topical antimicrobial agents may be applied to the wounds to prevent infection.
• Hand Hygiene: Frequent handwashing by healthcare providers and visitors.
• Isolation Precautions: If indicated, isolation precautions may be implemented to prevent the spread of infection.

Sample Solution

This is for informational purposes only. For medical advice or diagnosis, consult a professional.

Parkland Formula Calculation

Patient Information:

• Weight: 110 pounds = 50 kg (approximately)
• TBSA Burned: 30%
• Time of Admission: 0400

Parkland Formula:

Total Fluid Requirement = 4 mL/kg x %TBSA x Weight (kg)

= 4 mL/kg x 30% x 50 kg

= 6000 mL

Fluid Administration:

• First 8 hours (0400 - 1200):
  • 50% of total fluid: 3000 mL
  • Hourly rate: 375 mL/hour
• Next 16 hours (1200 - 0400):
  • 50% of total fluid: 3000 mL
  • Hourly rate: 187.5 mL/hour

Assessment Findings for Smoke Inhalation

• Respiratory:
  • Cough (productive or non-productive)
  • Wheezing
  • Stridor
  • Dyspnea
  • Tachypnea
  • Use of accessory muscles
  • Decreased breath sounds
  • Abnormal breath sounds (crackles, wheezes)
  • Sooty sputum
  • Hoarseness
  • Singed nasal hairs
  • Facial burns
• Cardiovascular:
  • Tachycardia
  • Hypotension
  • Arrhythmias
• Neurological:
  • Altered mental status
  • Confusion
  • Headache
  • Anxiety
  • Restlessness
  • Lethargy