Goal: Over the first 24–48 hours post burn, plasma is lost into the burned and unburned tissues, causing hypovolemic shock (when burn size is >20%). The goal of burn-shock resuscitation is to replace these ongoing losses while avoiding over-resuscitation.

 

Best: Isotonic crystalloids (e.g., lactated Ringer’s, Plasma-Lyte IV [Baxter, http://www.baxter.com/]);

 

Better: Enteral (oral or gastric) intake of electrolyte solution

 

Minimum: Rectal infusion of electrolyte solution. Rectal infusion of up to 500mL/h can be supplemented with oral hydration (see Hydration side bar.)