After the first 8 hours of fluid replacement using the Parkland formula, what rate should the nurse infuse IV fluids for a patient with a 40% TBSA burn?

To understand the calculation related to fluid replacement in burn patients, it's essential to apply the Parkland formula, which is commonly used to estimate the fluid needs of a burn victim in the first 24 hours after injury. The formula estimates that a patient requires 4 mL of Ringer's Lactate per kilogram of body weight for every percentage of Total Body Surface Area (TBSA) burned.

In this scenario, the patient has a burn of 40% TBSA. If you assume the patient weighs 70 kg (which is a common value used for such calculations), you begin by calculating the total fluid requirement using the formula:

Total fluid requirement in the first 24 hours = 4 mL x weight (kg) x TBSA (%)

= 4 mL x 70 kg x 40 = 11,200 mL over 24 hours.

The first 8 hours, you would infuse half of this total, which means:

Fluid requirement for the first 8 hours = 11,200 mL / 2 = 5,600 mL.

To establish the infusion rate for these first 8 hours, divide the total volume by the number of hours:

Infusion rate = 5,600 m