Parkland Burn Formula Calculator — IV Fluid Resuscitation for Burns

How to Use This Calculator

1. Enter the patient body weight in kg and TBSA burned (%) — excluding superficial first-degree burns.
2. Total 24h fluid volume, first 8h volume, and infusion rate display instantly.
3. Use the Modified Brooke tab to compare with the 2 mL/kg/% formula.
4. Use the TBSA Estimator tab (Rule of Nines) if you need to calculate TBSA from individual regions.
5. The Professional tier adjusts the first 8h rate if resuscitation started late.

Formula

Example

Frequently Asked Questions

• What is the Parkland formula? ▼
  The Parkland formula, also known as the Baxter formula, is the most widely used equation for calculating intravenous fluid resuscitation requirements in patients with major burns. Developed by Charles Baxter at Parkland Memorial Hospital in Dallas in the 1960s and 1970s, the formula is: Total fluid in 24 hours = 4 mL × body weight (kg) × total body surface area burned (% TBSA). The recommended fluid is Lactated Ringer's (Hartmann's solution). Half of the calculated volume is given in the first 8 hours from the time of burn (not from the time of hospital arrival), and the remaining half is given over the subsequent 16 hours. The formula applies only to partial-thickness (second-degree) and full-thickness (third-degree) burns; superficial (first-degree) burns are excluded from TBSA calculation.
• How is TBSA (Total Body Surface Area burned) estimated? ▼
  TBSA is estimated using two main methods. The Rule of Nines divides the adult body into regions each representing approximately 9% of BSA: head (9%), each arm (9%), chest (9%), abdomen (9%), upper back (9%), lower back (9%), each leg (18%), and perineum (1%), totalling 100%. The Rule of Nines is quick for initial assessment but less accurate in children, whose heads are proportionally larger. The Lund-Browder chart provides age-adjusted percentages and is more accurate, particularly in paediatric patients. For scattered, irregular burns, the patient's palm (including fingers) represents approximately 1% of TBSA and can be used to estimate small areas. Only partial-thickness and full-thickness burns are included; superficial (first-degree, red, blanching) burns are excluded.
• Why is Lactated Ringer's used instead of normal saline? ▼
  Lactated Ringer's solution (Hartmann's) is used for burn resuscitation rather than normal saline (0.9% NaCl) for several reasons. Normal saline has a chloride concentration of 154 mEq/L — significantly higher than plasma — which can cause hyperchloraemic metabolic acidosis when given in the large volumes required for major burns. Lactated Ringer's has a more physiological composition with 130 mEq/L sodium and 109 mEq/L chloride, plus lactate that is metabolised to bicarbonate, providing mild buffering. Several studies have confirmed lower rates of acute kidney injury and metabolic acidosis with Lactated Ringer's compared to normal saline in burn patients. Colloid-containing solutions (albumin, fresh frozen plasma) are sometimes added in the second 24 hours of resuscitation or from the start in paediatric patients, but Lactated Ringer's remains first-line for adults.
• What is "fluid creep" and how does it affect burn resuscitation? ▼
  Fluid creep is the clinical phenomenon of unintended over-resuscitation beyond the calculated Parkland volume in burn patients. Studies from the 2000s documented that many burn patients receive significantly more fluid than the Parkland formula calculates — sometimes double or triple the predicted volume. Fluid creep leads to severe oedema including abdominal compartment syndrome, extremity compartment syndrome, pulmonary oedema, and wound oedema that delays healing. Contributing factors include liberal titration protocols, use of opioids (which increase antidiuretic hormone), and practice drift away from strict formula adherence. Modern burn resuscitation emphasises goal-directed titration using urine output (target 0.5 mL/kg/hr in adults; 1 mL/kg/hr in children under 30 kg) rather than running pre-calculated rates, and acknowledging that the Parkland formula provides a starting point rather than a fixed target.
• What is the Modified Brooke formula and when is it preferred? ▼
  The Modified Brooke formula uses 2 mL/kg/% TBSA instead of Parkland's 4 mL/kg/%, giving half the crystalloid volume. It was developed at Brooke Army Medical Centre as an alternative that aims to reduce oedema and fluid creep. The initial 24-hour crystalloid volume is supplemented in some protocols with colloid (fresh frozen plasma or albumin) from the onset or after 8–12 hours, making the total oncotic fluid load more balanced. The Modified Brooke formula is used more commonly in the USA (particularly in military medicine) while Parkland remains more prevalent internationally. Meta-analyses have not demonstrated a clear mortality benefit of one over the other, and both require vigilant urine output monitoring and clinical reassessment. The choice is largely institutional; strict adherence to either formula with goal-directed titration is more important than which formula is used.

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