Parkland Formula Calculator For Burns

Variables and formula

The above calculator helps you determine the fluid requirement immediately after injury by burn, depending on the weight of the patient and the severity of burns.

This tool helps appropriately restore intravascular volume and limit the development of hypovolemic shock.

The equation it is based on, was created by Dr Charles Baxter at the Parkland Memorial Hospital in Texas and is addressed to adult patients, children and the elderly may require slightly lower or greater quantities of fluid.

The types of injuries that require fluid replenishment include:

■ >10% TBSA partial thickness burns;

■ Inhalation injury;

■ Burns to hands or genitals;

■ Any size full-thickness burn;

■ Serious chemical injury;

■ Serious electrical injury.

It is important that the patient is assessed frequently and that individual adjustments are made, with the scope to maintain adequate organ perfusion. In some patients, serum lactate can be used to check the hemostatic status but does not have individual predictive value for adequate fluid resuscitation.

The Parkland formula states that the fluid requirement (FR) is equal to total body surface burned multiplied by the patient weight and by 4:

FR = TBSA (%) x weight (kg) x 4 mL

This is the amount of fluid that needs to be administered first hard. The FR divided by 2 reveals the amount of fluid recommended at 8 hours after injury whilst the FR divided by 8 indicates the fluid recommended 24 hours after injury.

The Parkland method for initial fluid resuscitation has been validated and has proven its effectiveness in worldwide clinical settings. It is endorsed by the American Burn Association and is part of the protocol for burns treatment.

Burned body surface and Wallace rule

The Parkland formula requires the total burned body surface area which is estimated as a percentage according to the Wallace rule of nines.

This rule can be applied to both adults and children and provides a burn severity assessment.

The table below introduces the Wallace rule of nines:

Original source

Baxter CR. Fluid volume and electrolyte changes of the early postburn period. Clin Plast Surg. 1974; 1(4):693-703.

Validation

Cartotto RC, Innes M, Musgrave MA, Gomez M, Cooper AB. How well does the Parkland formula estimate actual fluid resuscitation volumes? J Burn Care Rehabil. 2002; 23(4):258-65.

Other references

1. Blumetti J, Hunt JL, Arnoldo BD, Parks JK, Purdue GF. The Parkland formula under fire: is the criticism justified? J Burn Care Res. 2008; 29(1):180-6.

2. Ahrns KS, Harkins DR. Initial resuscitation after burn injury: therapies, strategies, and controversies. AACN Clin Issues. 1999; 10(1):46-60.

3. Ahrns KS. Trends in burn resuscitation: shifting the focus from fluids to adequate endpoint monitoring, edema control, and adjuvant therapies. Crit Care Nurs Clin North Am. 2004; 16(1):75-98.