To determine the amount of fluid an adult patient should receive per hour during the first 8 hours of their care, we need to use the Parkland formula. This formula helps calculate the fluid requirements for burn patients based on their weight and the total body surface area (TBSA) that is burned.
Here is the step-by-step solution:
1. Determine the total burned area as a percentage of TBSA:
- Head: 1 (yes) => 9% of TBSA
- Left Arm: 0 (no) => 0% of TBSA
- Right Arm: 1 (yes) => 9% of TBSA
- Upper Front Torso: 1 (yes) => 9% of TBSA
- Upper Back Torso: 0 (no) => 0% of TBSA
- Lower Front Torso: 1 (yes) => 9% of TBSA
- Lower Back Torso: 0 (no) => 0% of TBSA
- Upper Left Leg: 0 (no) => 0% of TBSA
- Upper Right Leg: 0 (no) => 0% of TBSA
- Lower Left Leg: 0 (no) => 0% of TBSA
- Lower Right Leg: 0 (no) => 0% of TBSA
Adding these percentages together gives:
[tex]\( 9\% + 9\% + 9\% + 9\% = 36\% \)[/tex]
Converting this to a decimal, the total burned area = 0.36 (or 36%).
2. Apply the Parkland formula to calculate the total fluid needed:
- Parkland formula: [tex]\( 4 \text{ml} \times \text{TBSA} \times \text{body weight} \)[/tex]
- [tex]\( 4 \times 0.36 \times 77.5 = 111.6 \text{ml} \)[/tex]
3. Calculate the fluid needed in the first 8 hours:
- Half of the total fluid is needed in the first 8 hours.
- [tex]\( \frac{111.6}{2} = 55.8 \text{ml} \)[/tex]
4. Convert milliliters to liters:
- [tex]\( 55.8 \text{ml} = 0.0558 \text{liters} \)[/tex]
5. Determine the fluid per hour for the first 8 hours:
- Divide by 8 to find the hourly rate.
- [tex]\( \frac{0.0558}{8} \approx 0.007 \, \text{liters/hour} \)[/tex]
6. Round to the nearest hundredth of a liter:
- The fluid per hour should be 0.01 liters (which, when rounded to two decimal places, is 0.01).
So, the patient should receive approximately 0.01 liters per hour in the first 8 hours of their care.
