Parkland formula calculator (burn fluid resuscitation)
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Result
In practice the rate is adjusted to the urine output; the formula only gives the starting point. For exam practice only. This is a study aid, never a clinical decision: always follow the prescription, local protocols and the product information.
Calculate the fluid resuscitation volume for a burn patient with the Parkland formula: 4 mL × body weight in kg × percentage of total body surface area burned. Half of it is due in the first 8 hours from the time of the burn, not from arrival, and half over the next 16 hours. Enter the hours already passed and any fluid already given, and the calculator gives both infusion rates. Lower factors of 3 or 2 mL/kg/%TBSA are available too.
Step-by-step solution
Total fluid for the first 24 hours
First half in the first 8 hours after the burn
Second half over the next 16 hours
Key formulas
- Parkland formula
- 24-hour volume = 4 mL × kg × %TBSA
- First half
- ½ of the volume in the first 8 hours after the burn
- Second half
- the other ½ over the next 16 hours
- Hourly rate
- mL/h = volume still due / hours left
How to use the Parkland formula
- Estimate the %TBSA of partial and full thickness burns only (rule of nines or Lund and Browder chart); superficial burns are not counted.
- Total for 24 hours = 4 mL × weight (kg) × %TBSA: 4 × 70 × 30 = 8400 mL.
- Half (4200 mL) is due in the first 8 hours after the burn. If fluids start 2 hours after the burn, the rate is 4200 ÷ 6 = 700 mL/h.
- The other half runs over the next 16 hours: 4200 ÷ 16 = 262.5 mL/h.
- Subtract any fluid already given from the first half before working out the first rate.
Questions and answers
Why does the time count from the burn and not from arrival?
Fluid loss starts at the moment of the burn, so the first half is due 8 hours after the injury. A late start leaves less time and needs a higher rate.
Which fluid is used?
Lactated Ringer’s (Hartmann’s solution) is the classic crystalloid for the Parkland formula, as described by Baxter and Shires in 1968.
Why use 2 mL/kg/%TBSA instead of 4?
Too much fluid causes complications (fluid creep), so the American Burn Association advises starting with 2 to 4 mL/kg/%TBSA in adults; the modified Brooke formula uses 2. Use the factor the question gives.
How is the rate adjusted?
By the urine output: about 0.5 mL/kg/h in adults and 1 mL/kg/h in children is the usual target in exam questions. The formula only gives the starting rate.
From what size of burn is formal resuscitation used?
Usually from about 20% TBSA in adults and 10–15% in children; smaller burns can often be managed with oral fluids.
Practise it yourself
Practise IV fluids & fluid balance
A calculator gives the answer. In the exam you need the method: practise it with new problems, hints and worked solutions.