Fluid calculation for burn

this is a topic of medical surgical nursing for 3rd yr bsc and gnm which include calculation of fluids and its administration

1. BURN FLUID CALCULATION
DEPARTMENT
OF
MEDICAL SURGICAL NURSING

2. L EARNING OBJECTIVES
At the end of this lecture the students will be able to:
•Describe various formulas for fluid calculation of
burn

3. Management of Fluid loss and shock :
Forhaemodynamicstabilizationfluidresuscitationmay
beinitiatedimmediatelyonthebasisofthe
percentageofburninjury.Thegoaloffluid
resuscitationistogivesufficientfluidtoallow
perfusionofvitalorganswithoutoverhydratingthe
patientandriskinglatercomplicationandcirculatory
overload.

4. Somecombinationoffluidcategories
1)Colloids:-Wholeblood,plasma,andplasma
expenders.
2)Electrolyte:Physiologicsodiumchloride,Ringer’s
Sol,Hartmann’sSon.
Therearesomeformulawhichisuseiscalculatingfluid
forBurnpatient.

5. 1)Theconsensusformula
Itwasagreedthatsaltandwaterareessential
requirementofburnpatientbutthatcolloidmayor
maynotbeusefulduringthe1
st
24hoursto48
hourspostburn.

6. 1)Consensusformula:2to4ml/kgbodyWt%TBSA.
Planofadminister:1
st
8hours=halfshouldbegiven
andotherhalfshouldbegivenoverthenext16
hours.
Calculatione.g.70kgpt.with50%bodysurfacearea
burn.
2x70x50=7000ml/24hrs.
e.g.1
st
8hours=3500ml
Next16hrs=3500ml

7. 2)TheEvansFormula
(1)Colloids(bl,plasma,dextran)
1mlxkgbodywt.x%BSAburned
(2)Electrolyte1mlxkgbodywtX%BSA
burned.
(3)Glucose(5%inwater)2000mlfor
insensibleloss.
DayI:Totalallfluidsisgivenina24hrsperiod.Halfof
thecal.Fluidgiveninthe1
st
8hrs.postburn.The
remainingisspreadevenlyoverthenext16hrs.

8. Day II : The patient receive half of the colloid, half of
electrolyte and all insensible replacement.
e.g. 70 kg. patient with 50% burn surface area.
Colloids = 1ml x 70x50 = 3500ml
Electrolyte = 1ml x 70x50 = 3500 ml
3500ml +3500ml = 9000ml
Glucose = 2000 ml / 9000 ml.
1
st
Day Half of 9000 ml is 4500ml in 1
st
8 hrs.
4500ml -1000glucose = 3500ml electrolyte & colloids
remaining4500ml is spread evenly over the next 16 hrs.
Day II Colloids = 1750 ml
Electrolyte = 1750 ml
Glucose = 2000 ml
5500 ml

9. 3) The Brooke Army Hospital Formula:
(1)Colloids : 0.5 x kg body wt x% BSA burned
(2)Electrolyte : 1.5xkg body wt x% BSA burned.
(3)Glucose : 2000 ml.
Day 1
Day 2
e.g. 70 mg pt. with 50% burn surface
1)Colloids : 0.5 x 70x50 = 1750 ml
2)Electrolyte : 1.5x70x50 = 5250 ml
3)Glucose : 2000 ml
---------------
9000
Same as even formula

10. Day I : half of 9000 is 4500 ml in 1
st
8 hrs. and remaining
is spread evenly over the next 16 hrs.
Day II : Colloids = 875
: Electrolyte = 2625
: Glucose = 2000
----------------------
5500 ml / 24 hrs.

11. 4] The Parkland or Boxter Formula :
4ml x kg of body wt. x % burn
-Half is given in the 1
st
8 hrs and rest over the next 16
hrs.
e.g. 70 kg pt. with 50%.
4ml x 70 x 50 = 1400
7000 ml is given in 1
st
8 hrs and rest over the next 16
hrs.

12. Hypertonic saline :Conc. solution of NaCl and lactate
with cone. Of 300 mEg. of sodium, administered at a
rate sufficient to maintain desired urinary output
volume
Goal : Increased serum sodium level & osmolality to
reduce edema & pulmonary Complication.

13. Summary
•So far we have discussed about various
formulas for fluid calculation of burn

14. Bibliography
•Lewis et al, Medical Surgical Nursing, Mosby
Elsevier,7
th
edition.
•Joyce.M.Black et al, Medical Surgical Nursing,
Saunders publication.
•Brunner and Siddhartha, Medical Surgical
Nursing, Lippincott Williams and Wilkins.

15. Thank You