Question

an adult patient has come into the burn unit during your shift. you take an inventory of the location of their burns in the chart below.

part of body	burned? (1 = yes, 0 = no)
left arm	0
right arm	1
upper front torso	0
upper back torso	1
lower front torso	0
lower back torso	0
upper left leg	1
upper right leg	1
lower left leg	0
lower right leg	0

given that their weight/mass is 89.3 kg, determine how much fluid they should receive per hour in the first 8 hours of their care. answer to the nearest hundredth of a liter (two decimal places).

Explanation:

Step1: Calculate Total Burned Area (TBSA)

Using the Rule of Nines for adults:

• Head: 9% → Burned (1), so 9%
• Right Arm: 9% → Burned (1), so 9%
• Upper Back Torso: 9% → Burned (1), so 9%
• Upper Left Leg: 9% → Burned (1), so 9%
• Upper Right Leg: 9% → Burned (1), so 9%

Sum these percentages: \( 9 + 9 + 9 + 9 + 9 = 45\% \) or \( 0.45 \) (as a decimal).

Step2: Apply Parkland Formula for Fluid Resuscitation

The Parkland Formula is \( \text{Total Fluid in 24 hours} = 4 \times \text{weight (kg)} \times \text{TBSA (decimal)} \).

First, calculate total fluid for 24 hours:
\( 4 \times 89.3 \times 0.45 = 4 \times 40.185 = 160.74 \) liters (for 24 hours).

Step3: Find Fluid per Hour in First 8 Hours

In the first 8 hours, half of the 24 - hour fluid is given. So, fluid for 8 hours: \( \frac{160.74}{2} = 80.37 \) liters (for 8 hours).

Then, fluid per hour: \( \frac{80.37}{8} = 10.04625 \approx 10.05 \) liters per hour (rounded to two decimal places).

Answer:

\( 10.05 \)