PNLE 2025–2026 Burn Injury Triage, Parkland Formula & Wound Management (Board Exam Matrix & Recalls Vault)

Rule of Nines & Parkland Formula Calculation: RULE OF NINES (Adult): • Head & Neck: 9% (4.5% front, 4.5% back) • Chest & Abdomen: 18% • Upper & Lower Back: 18% • Each Arm: 9% (4.5% anterior, 4.5% posterior) • Each Leg: 18% (9% anterior, 9% posterior) • Perineum: 1% PARKLAND FORMULA (First 24 Hours): 4 mL × Body Weight in kg × % TBSA Burn = Total Lactated Ringer's (LR) • Give 50% in the FIRST 8 HOURS from time of injury! • Give remaining 50% over the next 16 HOURS! • Monitor Urine Output: Minimum 30-50 mL/hr (gold standard for resuscitation adequacy)! ---------------------------------------- PRACTICE BOARD QUESTION & RATIONALE: Q: A 70 kg client sustained 40% TBSA thermal burns at 10:00 AM. Arrives at the ED at 12:00 PM. How much Lactated Ringer's solution must be infused between 12:00 PM and 06:00 PM (the remaining 6 hours of the first 8-hour window)? A. 2,800 mL B. 5,600 mL C. 11,200 mL D. 1,400 mL Correct Answer: B. Total 24h volume = 4 mL × 70 kg × 40 = 11,200 mL. Half of this (5,600 mL) must be given in the first 8 hours calculated FROM TIME OF INJURY (10:00 AM to 06:00 PM). Since it is now 12:00 PM and none was given, all 5,600 mL must run over the remaining 6 hours.