Burn in neonate

Resuscitation

If signs of shock, resuscitate with sodium chloride 0.9%, 10-20 mL/kg bolus. Reassess after first fluid bolus and repeat as required.

.

Initial management

Burns resuscitation fluids according to the Modified Parkland Formula

To be added to the child’s normal maintenance fluids.

Calculate the volume required for fluid replacement using the following formula:

% TBSA x weight (in kg) x 2 mL

To assess the % TBSA use the Burns Body Surface Area Sheet (PDF).

https://pch.health.wa.gov.au/~/media/Files/Hospitals/PCH/General-documents/Health-professionals/ED-Guidelines/Flowchart-PDF/Burns-Surface-Area-sheet-PCH.pdf

Or just use this chart:

This gives an estimate of the volume of replacement fluid required in the first 24 hours from the time of the burn (not from time of arrival in hospital).

Administer this calculated volume using Hartmann’s solution (lactated ringer) as follows:

50% within the first 8 hours from the time of burn injury.

50% over the next 16 hours.

.

Maintenance

Determine child’s normal daily maintenance fluid requirement.