Parkland Burn Formula

CRNA Study Suite · Fluid Resuscitation for Burns
All Calculators Parkland
Patient & Burn
Rule of Nines (Reference)
RegionAdult %Child %
Head918
Each arm99
Chest (ant)1818
Back1818
Each leg1814
Perineum11
(Haglund & Phillips, 2023, p. 918)
Fluid Resuscitation Plan
Total 24-hr Volume
--
mL LR
First 8 hr (from injury)
--
mL
Next 16 hr
--
mL
Remaining Rate (now)
--
mL/hr
Target UOP
--
mL/hr
Phase
--
of resuscitation
Calculation Breakdown
1. Parkland (Baxter) Formula
Total 24 hr (mL LR) = 4 × weight (kg) × %TBSA burned
--
Total = -- mL over 24 hr
(Haglund & Phillips, 2023, pp. 920-921)
2. Split (from time of injury)
First 8 hr: 50% · Next 16 hr: 50%
--
3. Current Hourly Rate
Adjusted for hours already elapsed since injury
--
Run at -- mL/hr right now
4. Titrate to Urine Output
Target UOP 0.5-1.0 mL/kg/hr (adults). Parkland is a starting estimate — titrate to clinical endpoints.
--
References

Haglund, V. L., & Phillips, J. (2023). Anesthesia for burn patients. In S. Elisha, J. S. Heiner, & J. J. Nagelhout (Eds.), Nurse anesthesia (7th ed., pp. 917-929). Elsevier.

How this works

The Parkland formula

The Parkland (Baxter) formula estimates 24 hour crystalloid needs after a significant burn: 4 mL x weight in kg x percent TBSA burned, using lactated Ringer's (Haglund & Phillips, 2023, p. 920). Only partial thickness and full thickness burns count toward percent TBSA; superficial first degree burns are excluded (Haglund & Phillips, 2023, p. 918).

Timing and titration

Half of the 24 hour volume is given in the first 8 hours and the remaining half over the next 16 hours, both timed from the moment of injury, not from arrival (Haglund & Phillips, 2023, p. 920). Colloid is withheld for the first 24 hours. The formula is only a starting point and is titrated to a urine output of 0.5 to 1.0 mL/kg/hr in adults and 1.0 to 2.0 mL/kg/hr in children under 30 kg (Haglund & Phillips, 2023, pp. 920-921).

References

Haglund, V. L., & Phillips, J. (2023). Anesthesia for burn patients. In Elisha, Heiner, & Nagelhout (Eds.), Nurse anesthesia (7th ed., pp. 917-929). Elsevier.