American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the recommended distribution of fluids in the Parkland formula during the first 24 hours?

1. All in the first 8 hours

2. One quarter in the first 8 hours

3. One half in the first 8 hours

4. All in the last 16 hours

The correct answer is: One half in the first 8 hours

The Parkland formula is a widely used guideline for fluid resuscitation in patients with burns. The formula is calculated based on the total body surface area burned and involves administering a specific volume of crystalloids, typically Ringer's Lactate, within the first 24 hours following the burn injury. For this formula, the recommended distribution of fluids is to administer half of the total calculated volume during the first 8 hours. This rapid resuscitation is crucial because burn patients can be at high risk for hypovolemic shock due to fluid loss from the damaged skin and underlying tissues. Adequate fluid replacement in the initial hours is necessary to maintain blood pressure, tissue perfusion, and overall organ function. The remaining half of the fluid volume is given over the subsequent 16 hours. This staggered approach ensures that the patient remains hemodynamically stable and mitigates the risks associated with both under-resuscitation and fluid overload. This recommended distribution reflects the urgent nature of burn treatment, emphasizing that the first few hours after injury are critical for effective fluid management. By administering a significant portion of the fluids promptly, care teams can better manage the patient's condition and improve outcomes during the critical first day post-injury.