Search...
⌘K
Parkland Formula for Burns
Parkland Formula for Burns
Estimates fluid resuscitation needs in burn patients
Parkland Formula for Burns
Parkland Formula for Burns
Estimates fluid resuscitation needs in burn patients
Instructions
The Parkland Formula estimates the volume of fluid resuscitation required in the first 24 hours following major burn injury. Users input the patient’s weight and the percentage of total body surface area (TBSA) burned. The formula then calculates the total fluid volume required. Half of this amount is given within the first 8 hours from the time of injury, and the remaining half is administered over the next 16 hours.
Overview
When to use
Why use
Evidences
Interpretation
4 mL×Body weight (kg)×%TBSA burned
Rule of 9s:
Body Region | Adults (%) | Children (%) |
Head | 9% | 18% |
Each Arm | 9% | 9% |
Each Leg | 18% | 14% |
Front Torso | 18% | 18% |
Back Torso | 18% | 18% |
50% of the calculated fluid is given in the first 8 hours from the time of injury.
50% is given in the following 16 hours.
Use Ringer’s lactate as the preferred fluid.
Parkland formula overview (StatPearls): The Parkland formula, developed by Baxter (1968), recommends 4mL/kg/%TBSA of lactated Ringer in adults (3mL/kg/%TBSA in children), with half delivered in the first 8 hours from time of injury and the remainder over the next 16 hours; resuscitation is generally indicated for ≥20%TBSA in adults and ≥10–15%TBSA in children, counting only partial- and full-thickness burns.
https://www.ncbi.nlm.nih.gov/books/NBK534227/
American Burn Association (ABA) Clinical Practice Guideline on Burn Shock Resuscitation (2023/2024): Recommends initiating resuscitation at 2mL/kg/%TBSA rather than 4mL/kg/%TBSA to reduce “fluid creep,” titrating by urine output and perfusion markers; selective early albumin may be considered in larger burns to reduce total volume; emphasizes that any formula is a starting rate and must be adjusted to endpoints.
https://academic.oup.com/jbcr/article/45/3/565/7458089?login=false
Modern trends review: Parkland formula traditionally uses 4mL/kg/%TBSA with half in first 8 hours; contemporary practice recognizes risks of over-resuscitation and explores reduced volumes and colloid timing to mitigate edema-related complications.
https://www.sciencedirect.com/science/article/abs/pii/S0305417908003057
Overview
When to use
Why use
Evidences
Fluid resuscitation is a critical component of burn management, as significant fluid loss occurs due to increased capillary permeability, evaporation, and tissue damage. The Parkland Formula is the most widely used method for estimating initial fluid requirements in adults and children with major burns. It provides a structured approach that reduces the risk of hypovolemia and shock while preventing over-resuscitation, which can lead to complications such as pulmonary edema or compartment syndrome.
Accurate calculation and timely administration of fluids are essential for stabilizing circulation, preserving organ function, and improving survival. However, the Parkland Formula serves only as an initial guide. Ongoing monitoring of urine output, vital signs, mental status, and laboratory values is necessary to adjust fluid therapy according to the patient’s clinical response.
While the Parkland Formula is highly useful in acute care, clinicians must remain aware of its limitations. It does not account for inhalation injuries, electrical burns, or pre-existing comorbidities, which may significantly alter fluid requirements. Additionally, it should not replace clinical judgment but rather support rapid decision-making during the critical early period after injury.
Overview
When to use
Why use
Evidences
Interpretation
4 mL×Body weight (kg)×%TBSA burned
Rule of 9s:
Body Region | Adults (%) | Children (%) |
Head | 9% | 18% |
Each Arm | 9% | 9% |
Each Leg | 18% | 14% |
Front Torso | 18% | 18% |
Back Torso | 18% | 18% |
50% of the calculated fluid is given in the first 8 hours from the time of injury.
50% is given in the following 16 hours.
Use Ringer’s lactate as the preferred fluid.
Parkland formula overview (StatPearls): The Parkland formula, developed by Baxter (1968), recommends 4mL/kg/%TBSA of lactated Ringer in adults (3mL/kg/%TBSA in children), with half delivered in the first 8 hours from time of injury and the remainder over the next 16 hours; resuscitation is generally indicated for ≥20%TBSA in adults and ≥10–15%TBSA in children, counting only partial- and full-thickness burns.
https://www.ncbi.nlm.nih.gov/books/NBK534227/
American Burn Association (ABA) Clinical Practice Guideline on Burn Shock Resuscitation (2023/2024): Recommends initiating resuscitation at 2mL/kg/%TBSA rather than 4mL/kg/%TBSA to reduce “fluid creep,” titrating by urine output and perfusion markers; selective early albumin may be considered in larger burns to reduce total volume; emphasizes that any formula is a starting rate and must be adjusted to endpoints.
https://academic.oup.com/jbcr/article/45/3/565/7458089?login=false
Modern trends review: Parkland formula traditionally uses 4mL/kg/%TBSA with half in first 8 hours; contemporary practice recognizes risks of over-resuscitation and explores reduced volumes and colloid timing to mitigate edema-related complications.
https://www.sciencedirect.com/science/article/abs/pii/S0305417908003057
Frequently Asked Questions
Features and Services FAQs
Discover the full range of features and services we offer and how to use them.
Ready to Transform Your Practice?
Join thousands of clinicians saving hours daily with AI-powered documentation.
14-day free trial • No setup fees
Ready to Transform Your Practice?
Join thousands of clinicians saving hours daily with AI-powered documentation.
14-day free trial • No setup fees
Ready to Transform Your Practice?
Join thousands of clinicians saving hours daily with AI-powered documentation.
14-day free trial • No setup fees
DocScrib
AI-powered medical documentation platform revolutionizing clinical workflows through intelligent patient management and secure documentation.
DocScrib
AI-powered medical documentation platform revolutionizing clinical workflows through intelligent patient management and secure documentation.
DocScrib
AI-powered medical documentation platform revolutionizing clinical workflows through intelligent patient management and secure documentation.
Model for End-Stage Liver Disease (Combined MELD)