Pediatric burn management: what Normal Saline dosing is listed for burns in children?

• A. Normal Saline: 10 ml/kg
• B. Normal Saline: 15 ml/kg
• C. Normal Saline: 25 ml/kg
• D. Normal Saline: 20 ml/kg

Answer: (D)

In pediatric burn resuscitation, the starting approach uses a bolus of isotonic crystalloid at about 20 ml/kg. This amount is chosen because it quickly expands the circulating volume to improve perfusion without overwhelming a child’s smaller blood volume or causing fluid overload. After administering the bolus, fluid needs are guided by the child’s urine output and perfusion status, with adjustments made to meet ongoing needs and maintenance requirements. While adults often use the Parkland formula, pediatric protocols tailor resuscitation to the child’s physiology, and the 20 ml/kg starting dose reflects that balance. Too little fluid risks under-resuscitation and poor organ perfusion, while too much can lead to edema and respiratory compromise.