Parkland Formula

Calculate IV fluid resuscitation volume for burn patients in the first 24 hours. For adults and pediatric patients with burns >20% TBSA.

Indication

Calculate IV fluid resuscitation volume for burn patients in the first 24 hours. For adults and pediatric patients with burns >20% TBSA.

id: patient_type; label: Patient Type; type: options; options: value: adult; label: Adult (≥14 years); value: pediatric; label: Pediatric (<14 years)
id: weight; label: Weight (kg); type: number; placeholder: e.g. 70; note: Use actual body weight
id: tbsa; label: % Total Body Surface Area Burned (2nd + 3rd degree only); type: number; placeholder: e.g. 35; note: Do not include 1st degree burns. Use Rule of Nines for adults, Lund-Browder for children.
id: burn_time; label: Time Since Burn Injury; type: options; options: value: 0; label: Just occurred (<30 min ago); value: 1; label: 1 hour ago; value: 2; label: 2 hours ago; value: 3; label: 3 hours ago; value: 4; label: 4 hours ago; value: 6; label: 6 hours ago; value: 8; label: 8 hours ago

The first half is given in the FIRST 8 HOURS FROM THE TIME OF BURN — not from hospital arrival. If 4 hours have elapsed, the first half must be infused over the remaining 4 hours.
Use Lactated Ringer's solution — not normal saline. LR is preferred because NS causes hyperchloremic metabolic acidosis with large volumes.
The Parkland formula is a starting point — titrate fluids to urine output: 0.5 mL/kg/hr in adults, 1 mL/kg/hr in children. Insert a urinary catheter.
Avoid colloid in the first 8 hours — capillary leak means colloid will extravasate. Albumin can be added after 8 hours if needed.
The most common error is over-resuscitation (fluid creep) — associated with abdominal compartment syndrome, pulmonary edema, and increased mortality. Use urine output as your guide, not just the formula.
Pediatric patients have higher surface area to weight ratio and need maintenance fluids added to resuscitation volume — use dextrose-containing maintenance (D5LR) to prevent hypoglycemia.
Consider burn center transfer criteria: >10% TBSA partial thickness burns, full thickness burns, burns involving face/hands/feet/genitalia/perineum/major joints, inhalation injury, electrical/chemical burns.

Baxter CR. Fluid resuscitation of burn patients. Surg Clin North Am 1978; ATLS 10th Edition. Last reviewed: 2024-11-01