Parkland Formula for Burns

A reliable clinical tool to estimate fluid resuscitation needs for burn patients in the first 24 hours.

Important: Only include 2nd and 3rd degree (partial and full thickness) burns in the calculation.

Total 24-Hour Fluid (LR)
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First 8 Hours

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Next 16 Hours

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Note: Timing starts from the moment of injury.

Looking for more details? Read our comprehensive Parkland Formula guide

Formula Explanation

The Parkland formula is one of the most widely used burn fluid resuscitation formulas. It helps clinicians estimate the total volume of Lactated Ringer's solution required in the first 24 hours:

4 mL × Weight (kg) × TBSA (%)

Administration Protocol

  • First 8 hours: Deliver 50% of the total calculated volume.
  • Next 16 hours: Deliver the remaining 50% of the total volume.
  • Calculations should be based on the time of injury, not arrival at the hospital.

Case Scenario

Patient: A 40-year-old male weighing 80 kg presents with second and third-degree burns over his anterior trunk (18%) and right arm (9%), totaling 27% TBSA.

Calculation: 4 mL × 80 kg × 27% = 8,640 mL total for 24 hours.

Interpretation: The patient requires 8,640 mL of Lactated Ringer's in the first 24 hours. Half of this (4,320 mL) is given in the first 8 hours, and the remaining half over the next 16 hours.

Next Steps: Initiate IV fluid resuscitation immediately, monitor urine output (target 0.5 mL/kg/hr for adults) to titrate fluids.

Frequently Asked Questions

When does the 24-hour clock start for fluid resuscitation?

The 24-hour period starts at the exact time the burn injury occurred, not the time the patient arrived at the hospital. Any fluids given prior to arrival should be subtracted from the total.

Should I use this formula for superficial (first-degree) burns?

No. Only partial-thickness (second-degree) and full-thickness (third-degree) burns are included in the TBSA calculation for fluid resuscitation. Erythema alone is not counted.

References

  1. Baxter CR. Fluid volume and electrolyte changes of the early postburn period. Clin Plast Surg. 1974;1(4):693-703.
  2. Advanced Trauma Life Support (ATLS) Student Course Manual. American College of Surgeons.

How to Use

Enter the patient's weight and the Total Body Surface Area (TBSA) affected by 2nd and 3rd-degree burns. The tool calculates the fluid requirement for the first 24 hours.

Clinical Guidance

Burns Resuscitation Guidance
  • Resuscitation fluid: Lactated Ringer's (LR) is the preferred crystalloid of choice. Do not use normal saline as it can cause hyperchloremic metabolic acidosis.
  • Timing: The first 8-hour period starts from the time of the injury, not the time of arrival at the hospital or initiation of medical care. Adjust the rate accordingly if arrival is delayed.
  • Target Urine Output (UOP): Titrate fluids to maintain urine output of 0.5 to 1.0 mL/kg/h in adults (or 30-50 mL/h), and 1.0 to 2.0 mL/kg/h in children under 30 kg.
  • Cardiac/Renal comorbidities: Use caution and closer monitoring in elderly patients or patients with heart failure/chronic kidney disease to avoid fluid overload.