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Burns And Fluid Replacement

When a person is burned and depending on the severity of burn, the blood vessels including the capillaries may be affected. Combined with the release of chemical substances into the blood, this will lead to increased capillary permeability to fluids, leading to the leaking of fluids from the blood vessels into the tissues. The higher the percentage of burned skin, the more severe the loss of fluid will be and the greater the dehydration will be.

Fluid replacement is one of the important objectives in the initial treatment of burned patients. The amount of fluid needed and the method of fluid given depends on the surface area of the skin burned as well as other factors. There are many formulas used for fluid resuscitation; one of them is called the Parklund Formula in which after the amount of fluids is calculated, it is given through an IV route and the type of fluid is usually Ringer Lactate. Urine output (0.5 ml/kg/hour in adult and 1 ml/kg/hour in children) is one of the methods used to evaluate adequate fluid resuscitation.

  • Fluid is replaced to prevent hypovolemic shock and other associated complications such as kidney failure.
  • Patients with minor burns can be resuscitated with oral rehydration therapy. You have to make sure that your child is taking enough fluids, is not vomiting and that he/she is producing a satisfactory amount of urine.
  • Ringer lactate is usually given because it’s composition is most like normal extracellular fluid.
  • Fluid that leaks from the burned area can accumulate in the burned area only if the burned area was small; if the burned area was large this may lead to accumulation of fluid everywhere in the body.
  • Edema (accumulation of fluid in bodily tissue or body cavity) may become worse after fluid resuscitation and if this edema is in a compartment (closed space of nerves, muscle tissue and blood vessels) covered by dead tissue as a result of the burn which is inelastic and can’t expand, this edema may lead to compression of the blood vessels in the compartment leading to compression of circulation in which escharotomy may be needed to release that pressure. It is advisable to watch the burned areas, especially in the extremities, for signs of decrease blood flow to the affected area (see Escharatomy) after fluid resuscitation.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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