# Parkland Formula Calculator For Burns

Determines the fluid for immediate, 8 and 24h administration based on patient weight and burn severity.

The Parkland formula calculator for burns can be used to determine the required fluid for immediate fluid replenishment and for administration at 8 and 24h after burn.

It is based on the patient’s weight and the severity of the burns in percentage of total body surface affected.

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

The Parkland formula states that the fluid requirement (FR) is equal to total body surface burned (%) multiplied by weight (kg) and by 4 (mL).

The FR is divided by 2, respectively 8 to determine the amount of fluid to be administered 8 and 24h after burn.

Patient weight
Percentage of body burned

Adults: By the rule of 9's it is recommended: 9% for each arm, 9% for head, 18% for each leg, 18% for front torso and 18% for back torso.

Children: According to the rule of 9's it is recommended: 9% for each arm, 14% for each leg, 18% for head, 18% for front torso and 18% for back torso.

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Steps on how to print your input & results:

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.

## 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:

 Region Adults Children Head 9% 18% Front torso 18% 18% Back torso 18% 18% Arms 9% for each 9% for each Legs 9% for each 14% for each

## 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.

Specialty: Emergency

Objective: Determination

Type: Calculator

No. Of Variables: 2

Year Of Study: 1974

Article By: Denise Nedea

Published On: June 14, 2017

Last Checked: June 14, 2017

Next Review: June 14, 2023