Comments on: 2009 TCCC Guidelines

By: Dom

Dom — Fri, 06 May 2011 21:22:22 +0000

The burn formula that is above is the new Institute of Surgical Research rules of ten. It currently substitutes the parkland burn formula for military personnel. This is the golden standard according to the Committee of TCCC. What they have found with the parkland burn formula is that, patients are being flooded with fluids when not needed.
“– Initial IV/IO fluid rate is calculated as %TBSA x 10cc/hr for adults weighing 40-80 kg.
– For every 10 kg ABOVE 80 kg, increase initial rate by 100 ml/hr.”
Say for instance you have a patient who weights approximately 90kg with 30% body surface area (BSA) burned then, according to the ISR rules of ten, 30% x 10cc = 300, but since the patient weights 10kg more than the formula you add an additional 100cc, making it 400cc/hr. Your overall affect is to get 30-50 cc urine output. Once you have this achieved maintain urine output.

By: Aaron Oosterhart

Aaron Oosterhart — Sat, 08 Jan 2011 08:46:00 +0000

Hey guys, in the updated “Burns” sections, in part “d.” of both:

“– Initial IV/IO fluid rate is calculated as %TBSA x 10cc/hr for adults weighing 40-80 kg.
– For every 10 kg ABOVE 80 kg, increase initial rate by 100 ml/hr.”

If 1cc = 1ml, which it does, it seems odd to me that for adults weighing 40-80 kg that infusion would start at 10cc/hr (10ml/hr) but for every 10kg above 80kg you would add an additional *100ml/hr (100cc/hr)*. why would you make an increase at the rate of an entire order of magnitude for an extra ten kilos? I’ve not checked it out yet, but there is either a zero missing from the “initial” dosing or a zero was added to the “supplemental” dosing recommendations… I’ll look into this further when I have some time (winter term classes just started) unless someone else already knows or has an answer to this….

By: Joel Paskauskas

Joel Paskauskas — Mon, 03 May 2010 00:27:24 +0000

very just what I needed