Parkland Formula (Burns)
Fluid resuscitation calculation for burn patients
Calculator
Why use it
Standard initial estimate for burn fluid resuscitation. Prevents under-resuscitation (renal failure, shock) and over-resuscitation (compartment syndrome, pulmonary edema). Starting point — titrate to urine output.
About
The Parkland formula (also Baxter formula) calculates the estimated crystalloid fluid requirement for the first 24 hours of resuscitation in major burn patients. It uses body weight and total body surface area (TBSA) burned. Half of the total is given in the first 8 hours from time of burn, and the remaining half over the next 16 hours.
When to use
- Burns > 20% TBSA in adults, > 10% in children
- Initial fluid resuscitation planning for burn patients
- Burn center transfer preparation
Formula
Pearls & pitfalls
- The formula provides an ESTIMATE — always titrate to clinical endpoints (urine output, vitals, lactate).
- Half the total volume in the first 8 hours from TIME OF BURN, not time of presentation.
- Use Lactated Ringer (LR) — avoid normal saline (hyperchloremic acidosis risk).
- TBSA estimation: Rule of 9s (adults), Lund-Browder chart (children) — only count 2nd and 3rd degree burns.
- Patients with inhalation injury, delayed resuscitation, or electrical burns often require more than Parkland estimate.
- "Fluid creep" — over-resuscitation is increasingly recognized; stay goal-directed.
Next steps
Start Lactated Ringer at calculated rate. Titrate to urine output: 0.5-1.0 mL/kg/hr (adults), 1.0-1.5 mL/kg/hr (children). Monitor for compartment syndrome, abdominal compartment syndrome, and pulmonary edema.
Evidence
Developed at Parkland Memorial Hospital (Baxter & Shires, 1968). ABA (American Burn Association) guidelines recommend 2-4 mL/kg/%TBSA as initial estimate. Modified Brooke formula uses 2 mL/kg/%TBSA as an alternative starting point.