Calculates 24-hour fluid resuscitation for burn patients
Total Score
Total Ringer's Lactate in 24h (mL). Administer 50% in first 8 hours from time of injury; remaining 50% over next 16 hours. Titrate to urine output 0.5 mL/kg/hr (1 mL/kg/hr in children). Reassess frequently — fluid creep is a real risk.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
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The Parkland Burn Formula is the cornerstone of initial burn resuscitation. It estimates the volume of Ringer's Lactate required in the first 24 hours post-burn to counteract the profound hypovolemic shock resulting from massive capillary leak. The formula calculates 4 mL multiplied by the patient's weight in kg and the % Total Body Surface Area (TBSA) burned, with half the volume administered in the first 8 hours.
The formula is strictly a starting point. Modern burn care emphasizes avoiding 'fluid creep' (over-resuscitation causing compartment syndromes). The Advanced Burn Life Support (ABLS) guidelines now recommend starting at 2 mL/kg/%TBSA for adult thermal burns. Regardless of the formula, fluid rates MUST be titrated continuously to maintain a urine output of 0.5 mL/kg/hr.
Baxter CR. Fluid volume and electrolyte changes of the early postburn period. Clin Plast Surg. 1974;1(4):693-703.
American Burn Association. Advanced Burn Life Support (ABLS) Provider Manual. Chicago, IL; 2018.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Apply to adults and children with major burns (typically ≥ 15% TBSA in adults, ≥ 10% in children) requiring intravenous fluid resuscitation. Calculate %TBSA using the Rule of Nines (adults) or Lund-Browder chart (children and modified adults). Exclude first-degree (superficial epidermal) burns and areas of blistering-only from the TBSA estimate. Initiate Ringer's Lactate as the preferred resuscitation fluid; normal saline is avoided due to the risk of hyperchloraemic acidosis in large volumes.
The Parkland formula is a starting point, not a prescription. Urine output is the most practical real-time resuscitation endpoint: target 0.5 mL/kg/hr in adults and 1 mL/kg/hr in children < 30 kg. If urine output is inadequate at the calculated rate, increase by 20% and reassess; do not reflexively bolus, as boluses contribute to "fluid creep" — the progressive resuscitation escalation that causes abdominal compartment syndrome, pulmonary oedema, and extremity compartment syndromes.
The "8-hour clock" starts from the TIME OF BURN INJURY — not from ED arrival. If a patient arrives 3 hours post-injury, the first half of the calculated volume must be administered in the remaining 5 hours (not 8). Failure to account for prehospital time results in systematic under-resuscitation during the critical first hours and over-infusion compression into a shorter window. Always document the exact injury time and recalculate fluid rates on arrival.
Baxter CR.. Fluid volume and electrolyte changes of the early postburn period. Clinics in Plastic Surgery. 1974;1:693–703.
American Burn Association. Advanced Burn Life Support (ABLS) Provider Manual. American Burn Association. 2018:Chicago, IL.