In major burns, two large IV cannulae are needed. Plus maintenance fluids for children less than 40kg. Plus maintenance fluids. Additional Hartmann's if needed to maintain urinary output. Very young child.
Decreased requirements occur with pre-existing cardiac disease.
If patient is not responding to crystalloid therapy, then colloid can be commenced in the second 12 hours. It must be stressed that these formulae provide a guide only to fluid replacement. If however, anuria has been present for some time an experienced person should assess the situation. The patient must be regularly assessed. Anxiety and restlessness are early signs of hypovolaemia and hypoxaemia.