For burns greater than 9% TBSA that are second or third degree, a fluid bolus is indicated.

For burns greater than 9% TBSA that are second or third degree, a fluid bolus is indicated.

• A. False
• B. Not necessarily
• C. Only for inhalation injury
• D. True

Answer: (D)

When a burn is deep (second- or third-degree) and involves a substantial portion of the body, the damaged skin and capillary leak cause significant fluid shifts out of the circulating volume. This puts the patient at risk for burn shock, so early IV fluid resuscitation is needed to maintain tissue perfusion and organ function. A burn exceeding about 9% TBSA with depth in this range is a threshold where giving a fluid bolus is indicated in the field. You’d typically start with an isotonic crystalloid (such as normal saline or lactated Ringer’s) around 20 mL/kg IV, then reassess—watch urine output and vital signs and repeat or adjust as needed. Inhalation injury can complicate the situation and may raise fluid needs, but the decision to give a bolus in this scenario is driven by burn size and depth, not inhalation alone. Therefore, the statement is true.

When a burn is deep (second- or third-degree) and involves a substantial portion of the body, the damaged skin and capillary leak cause significant fluid shifts out of the circulating volume. This puts the patient at risk for burn shock, so early IV fluid resuscitation is needed to maintain tissue perfusion and organ function. A burn exceeding about 9% TBSA with depth in this range is a threshold where giving a fluid bolus is indicated in the field. You’d typically start with an isotonic crystalloid (such as normal saline or lactated Ringer’s) around 20 mL/kg IV, then reassess—watch urine output and vital signs and repeat or adjust as needed. Inhalation injury can complicate the situation and may raise fluid needs, but the decision to give a bolus in this scenario is driven by burn size and depth, not inhalation alone. Therefore, the statement is true.