In the pediatric Parkland formula, the total fluid to be given in the first 24 hours is calculated as:

• A. 3 x kg x TBSA
• B. 5 x kg x TBSA
• C. 2 x kg x TBSA
• D. 4 x kg x TBSA

Answer: (A)

In pediatric burn management, resuscitation follows the Parkland concept but with a smaller coefficient than in adults. The volume for the first 24 hours is based on body weight and the TBSA burned, using 3 mL per kilogram per percent TBSA. So the total fluid equals weight in kg × TBSA × 3. Half of that amount is given in the first 8 hours after the burn, and the remaining half over the next 16 hours, with time counted from the moment of the burn (not arrival at the hospital). Lactated Ringer’s is commonly used, and you adjust ongoing fluid to maintain adequate urine output and perfusion. The other multipliers would either over- or under-estimate fluids for children, since 4 mL/kg/%TBSA is the adult value, while 2 or 5 do not fit pediatric practice.