The "10 rule for burns" is used to calculate the initial intravenous fluid resuscitation rate for adult burn patients weighing between 40 kg and 80 kg.
Understanding the Rule
The rule focuses on the percentage of Total Body Surface Area (%TBSA) affected by the burn and applies this to calculate the necessary fluid rate. Here's a breakdown:
Formula
- Initial Fluid Rate (mL/hr) = %TBSA x 10
Explanation
- %TBSA: This represents the estimated percentage of the body's surface that has been affected by the burn. Estimating TBSA is critical for determining fluid requirements.
- 10: This number is the constant multiplier in the formula and helps establish the initial fluid resuscitation rate in milliliters per hour.
Example
Let's say a patient has a burn covering 30% of their TBSA. Using the rule:
- Initial Fluid Rate = 30 (TBSA %) x 10 = 300 mL/hr.
This means the patient will initially receive 300 mL of intravenous fluid per hour.
Considerations for Patients Outside the 40-80 kg Range
The standard rule is for patients between 40 kg and 80 kg. Adjustments are needed for larger patients.
- For Every 10 kg over 80 kg, add 100 mL/hr.
For example, if a patient weighs 90 kg and has a 30% TBSA burn:
- Initial Rate (based on TBSA) = 30% x 10 = 300 mL/hr
- Additional rate due to weight = 100mL/hr (for 10kg above 80kg)
- Total initial rate = 300 + 100 = 400 mL/hr
Key Takeaways
- The '10 rule' is a simple calculation for initial fluid resuscitation in adult burn patients.
- It calculates the initial intravenous fluid rate, not the total amount of fluid needed.
- It is crucial to adjust for patients weighing more than 80kg.
- This is a guideline and individual patient response to fluid resuscitation must be assessed and treatment adjusted accordingly.
Important Note
This is an initial estimate and actual fluid requirements must be monitored. Vital signs, urine output, and overall clinical presentation should be carefully evaluated to guide ongoing fluid management. Also it is important to note that there are other calculations for fluid resuscitation in burn patients and they may be more appropriate depending on the clinical situation, and local guidelines.
