Instructions

A. Fluid deficit after burn

1. Calculate total burn area (Rule of Nines; Lund and Browder chart). Round to nearest 10%.
2. Estimate / measure the patient’s weight and round to nearest 10kg.
3. Read off the fluid deficit (in millilitres – white section) from time elapsed since burn (in hours – grey section).
4. Deduct the volume of any fluid already administered.
5. Replace deficit with Hartmann’s solution only.

B. Maintenance fluid after burn

1. Read the hourly maintenance requirement (ml) from the purple section and replace as Hartmann’s solution.
2. Start this replacement at the same time the deficit is replaced.
3. Note that the hourly requirement changes after 8 hours from the burn.
4. Colloid is required after the first 8 hours following burn for children and after the first 24 hours for adults.

Specialist burns advice essential