Hear me correctly. Do not blindly answer. Check your sources and let me know whether I'm correct or wrong. In case of burns, patient comes to the hospital after three hours of the burns. So first half of the calculated fluid resuscitation should be done in eight hours, irrespective of time since burn. Means burn happened at 9 a.m. in the morning. Patient came at 1 p.m. So first half of the fluid should be given from 1 p.m. to 8 p.m. But second half of the fluid should be given from 16 hours since burn, that is 16 hours from 9 o'clock. Am I correct?
Reading File
Finding Sources
Searching the Web
burn fluid resuscitation Parkland formula delayed presentation first half 8 hours from time of burn
Reading File
Finding Sources
I now have clear, consistent answers from multiple authoritative sources. Here is the verdict:
You Are PARTIALLY Correct - With One Important Error
What you got RIGHT:
The first half of fluids is counted from the time of burn injury (9 AM), not from when the patient arrives. So if the burn happened at 9 AM and the patient arrives at 1 PM, the 8-hour window from the burn ends at 5 PM - not 8 PM. This means you must give the first half of the fluids in only the 4 remaining hours (1 PM to 5 PM), at a faster rate to compensate for the lost time.
The second half is given over the next 16 hours after the first 8-hour period ends, which would start from 5 PM (8 hours post-burn) and end at 9 AM the next day (24 hours post-burn).
Where you went WRONG:
Your statement has two errors:
-
"First half from 1 PM to 8 PM" is wrong. You said the first half should run until 8 PM. That would be 11 hours after the burn, not 8. The first 8-hour window ends at 5 PM (9 AM + 8 hours), not 8 PM. The fluid should be given between 1 PM and 5 PM - which is only 4 hours remaining, so you'd need to infuse it faster.
-
"Second half from 16 hours since burn" is wrong. The second half does NOT start at 16 hours post-burn. It starts immediately after the first 8 hours end (i.e., from the 8-hour mark) and runs for the next 16 hours, completing the full 24-hour resuscitation window. The "16 hours" refers to the duration of the second half, not the start time.
The Correct Rule (from StatPearls - Parkland Formula and Bailey & Love's Surgery, p.692):
| Period | Duration | Timing in Your Example |
|---|---|---|
| First half of fluid | First 8 hours post-burn | 9 AM → 5 PM (patient arrives late, so infuse faster: 1 PM → 5 PM) |
| Second half of fluid | Next 16 hours post-burn | 5 PM → 9 AM next day |
Both halves are calculated from the time of burn, not time of arrival. If the patient is late, the first half must be given faster to catch up within the same 8-hour window ending at 5 PM.
Summary: The clock starts at the time of burn for BOTH halves. Your concept of backdating to the burn time was correct in principle, but your specific timings (1 PM to 8 PM for first half, and "16 hours from burn" for second half) were incorrect.
This is a shared conversation. Sign in to Orris to start your own chat.