A 45-yrs-old firefighter who weights 74 kg sustains a third-degree burn to 64 percent of his total body surface area. The patient arrives in the emergency depament approximately 30 min after the time of the accident. When the patient's intravenous fluid requirements are calculated using the Parkland formula, the initial orders for choice of fluid and rate of infusion should be

The Parkland formula for calculating the amount of fluid needed for resuscitation of burned patients calls for 4mL of Ringer's lactate per kilogram of body weight per percentage of total body surface area of second and third-degree burns. Ringer's lactate solution alone is administered for the first 24 h after injury, and one- half of the 24-h requirement should be administered in the first 8 h from the time of injury. In the case described in the question, in which the patient weighed 74 kg, suffered a third-degree bum to 64 percent of his total body surface area, and arrived for treatment a half hour after injury, fluid requirements would be calculated as follows. 4mlx74kgX64= 18,944ml 18,944/2 = 9,472 ml over the next 1/2h 9,472/75 = 1,262 ml/h