Parkland Formula for Burns Calculator
What is the Parkland Formula?
The Parkland Formula (also known as the Baxter Formula) is a guideline used to calculate the fluid resuscitation requirements for patients with significant burn injuries during the first 24 hours after the burn occurred. It was developed by Dr. Charles Baxter at Parkland Memorial Hospital in Dallas, Texas.
Proper fluid resuscitation is critical in burn management to prevent burn shock, which can occur due to increased capillary permeability and fluid shifts following a severe burn injury.
The Formula
Total fluid requirement (in mL) = 4 × Weight (kg) × TBSA burned (%)
Where:
- Weight is the patient's weight in kilograms
- TBSA is the total body surface area burned, expressed as a percentage
The calculated fluid volume is typically administered as follows:
- First 8 hours: 50% of the total calculated fluid
- Next 16 hours: Remaining 50% of the total calculated fluid
The fluid of choice is typically Lactated Ringer's solution or another isotonic crystalloid.
Clinical Applications
The Parkland Formula is used for:
- and pediatric patients with significant burn injuries (typically > 15-20% TBSA)
- Initial fluid resuscitation planning in the first 24 hours post-burn
- Guiding fluid therapy to prevent burn shock and organ hypoperfusion
Limitations and Considerations
While the Parkland Formula provides a useful starting point for fluid resuscitation, it has several limitations:
- It provides only an estimate; actual fluid requirements may vary
- Fluid administration should be adjusted based on clinical response
- Urine output (target 0.5-1 mL/kg/hr in s) is a key indicator for adequacy of resuscitation
- The formula may overestimate fluid needs in some patients
- Additional factors like inhalation injury may increase fluid requirements
- Children may require maintenance fluids in addition to resuscitation fluids
Monitoring During Fluid Resuscitation
Patients receiving fluid resuscitation based on the Parkland Formula should be monitored for:
- Urine output (primary indicator of adequate resuscitation)
- Vital signs (heart rate, blood pressure)
- Mental status
- Peripheral perfusion
- Laboratory values (electrolytes, hematocrit, lactate)
- Signs of fluid overload or under-resuscitation
References
- Baxter CR. Fluid volume and electrolyte changes in the early post-burn period. Clin Plast Surg. 1974;1(4):693-703.
- Cancio LC, et al. Standard variables fail to identify patients who will not respond to fluid resuscitation following thermal injury: brief report. Burns. 2005;31(3):358-365.
- Greenhalgh DG. Burn resuscitation: the results of the ISBI/ABA survey. Burns. 2010;36(2):176-182.