help with the brooke formula for burns

[Kitty Hawk, ADN, RN]

Okay...we were told to know this. I got the 2 ml/LR x kg/wt x TBSA

Let's say that the total of the above is 8000ml. I understand 1/2 is given the 1st 8 hours and the other 1/2 of the next 16hrs. I also get that you have to time it from time burned not brought in. Here's where I need the help.

Say the person was burned at 7am brought in at 3pm 8hours are already gone so is it the 8000ml or is it doubled, or what???

Then, what is happening over the next 16 hours?

If you could also give me a scenario burned at 7am brought in at 10am, so I can see the difference and hopefully make the connex. So far I can't find actual problems to help me solidfy this in my head, not even in Saunder's NCLEX so I turned to you guys! We have a test Friday and we were told there may be tricks!

TIA

[airforce07, RN]

hi tia:

hopefully this gives you a more clear understanding for your question...

your understanding of the basics is excellent... now don"t get distracted

from the half of the volume you are do in in 8 hours... ok...

here we go a more clear example...

8000 ml lr is your total half to recover this burn victim during his first 8 hours right?

so what you do next is important...

when you are getting report make sure you have a clear idea of what the patient got in the field...(paramedics, airflight etc.) then how much the patient got in er...

now lets say... your patient got 3300 total... from the time of the burn... 0700 and you got him in your unit at 1000 in the morning... all you have to do is substract. so... 8000-3300=4700 ml left for you to infuse in the next 5 hours.

now there are other factors you should look closely...

1. urine output 50ml/hr at least

2. hypotension... not enough lr fluid replacement... you might have to adjust your formula maybe to 4ml.tbsa.kg

3. tachycardia... again look for hypovolemic shock signs and symptoms...

4. hypothermia... please pay close attention for this sign as this is the most cardinal and critical sign to monitor and manage in your burn patient...

thanks

air burn nurse...