Estimating fluid therapy in burns..a simple formula

Use the rule of 10’s to start

  1. Estimate burn size to the nearest 10%.
  2. Multiply %TBSAx10 = Initial fluid rate in mL/hr (for adult patients weighing 40 kg to 80 kg).
  3. For every 10 kg above 80 kg, increase the rate by 100 mL/hr.

So let’s say we had patients of different weights with 27% burns, the calculated rates (mL/hr) for each of the approaches are:



Although you can’t possibly know by looking at the single images, for what it is worth, the above cases are; A = metastasis, B = abscess, C = radiation necrosis, D = GBM, E = demyelination, F = contusion.

These six ring enhancing brain lesions are each due to a different cause. What mnemonic is handy here?

Hydropneumothorax in a post pneumonectomy patient

Hydropneumothorax in a post pneumonectomy patient. Note the perfectly horizontal fluid line due to a true air-fluid interface rather than a fluid meniscus that would be typical of a pleural effusion in the absence of a pneumothorax. Also note the volume loss on the effected side rather than positive mass effect consistent with the lung having been removed.