Board Review: Pediatric Burns

A 3 year old child weighing 30 kg is brought to your emergency department following a burn.  After careful examine, you determine that she has first degree burns to 10% of her total body surface area and second degree burns to 20% of her total body surface area.  What amount of fluid should you give her in the first 8 hours for appropriate fluid resuscitation?  (scroll down for the answer)

a) 1760 mL

b) 1200 mL

c) 560 mL 

d) 1400 mL

e) 2200 mL 




















The correct answer is a) 1760 mL  =  [ (4mL/kg x 30kg x 20%) / 2  ] + ( 70mL/hr x 8hr ) 

The Parkland Formula can be used to calculate fluid resuscitation of burn patients.  Parkland Formula: fluids in first 24 hrs (mL) = 4 (mL/kg) x weight (kg) x % total body surface area of burn.  It is important to remember that only second and third degree burns are included in the Parkland Formula.  Half of the total volume calculated using the Parkland Formula is given over the initial 8 hours and the second half is given over the following 16 hours. 

It is also important to remember that for children under the age of 5 years old, maintenance fluids must also be included in resuscitation.  Maintenance fluids for pediatrics can be calculated using the Holliday Segar Rule (4: 2: 1). 


1 Stapczynski, J. Stephan,, and Judith E. Tintinalli. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: McGraw-Hill Education LLC., 2011.