What is the Parkland formula?

The Parkland formula estimates the fluid a burn patient needs in the first 24 hours: 4 mL of Ringer's lactate per kilogram of body weight per percent of total body surface area burned. Half is given in the first 8 hours and half over the following 16 hours.

When does the 8-hour clock start?

It starts at the time of the burn injury, not the time of hospital arrival. If two hours have already passed before resuscitation begins, the first half must be delivered over the remaining six hours, so the initial rate is higher.

What counts toward percent TBSA?

Only second-degree (partial-thickness) and deeper burns are counted. Superficial first-degree burns, like simple sunburn, are excluded. Extent is usually estimated with the rule of nines in adults or a Lund-Browder chart for greater accuracy and in children.

Is the calculated volume a fixed target?

No. The Parkland number is only a starting estimate. The infusion is then titrated to physiological endpoints, chiefly a urine output of about 0.5 mL/kg/hr in adults and 1 mL/kg/hr in children, adjusting up or down as needed.

Which fluid does the formula use?

Lactated Ringer's solution is the standard crystalloid for Parkland resuscitation. Colloids and other fluids are sometimes added later in the course, but the formula itself specifies Ringer's lactate for the first 24 hours.

What is the Parkland Burn Formula — IV Fluid Resuscitation?

Apply the Parkland formula (4 mL x kg x percent TBSA) to compute the total 24-hour Ringer's lactate volume for a burn patient, split into the first-8-hour and next-16-hour rates timed from injury. Used in burns units and emergency departments. Runs in your browser. It runs free in your browser on Gera Tools, with nothing uploaded.

Parkland Burn Formula — IV Fluid Resuscitation

Name: Parkland Burn Formula — IV Fluid Resuscitation
Creator: Gera Tools
License: https://creativecommons.org/licenses/by/4.0/

Get one useful tool a week

Like this tool? Enter your email and we'll send you one genuinely useful Gera tool a week — plus a link to come back to this one. No spam, one-click unsubscribe any time.

The Parkland formula is the most widely taught method for estimating intravenous fluid needs in the first 24 hours after a significant burn. Severe burns cause massive fluid shifts out of the circulation — capillary permeability increases sharply in the burned area, causing plasma to leak into the interstitium. Under-resuscitation leads to hypovolaemic shock; over-resuscitation causes oedema, abdominal compartment syndrome, and respiratory complications. A defensible starting estimate is therefore essential.

The formula

total 24h volume = 4 mL × weight(kg) × %TBSA
first 8h volume  = total ÷ 2   (timed from the MOMENT OF INJURY, not arrival)
next 16h volume  = total ÷ 2

The infusion rate for each phase is the phase volume divided by its duration. Because the 8-hour clock starts at the time of the burn injury rather than at hospital arrival, any pre-hospital delay compresses the first window and raises the early rate to compensate.

What counts toward %TBSA

Only partial-thickness (second-degree) and deeper burns are included. Superficial first-degree burns — simple erythema, intact skin — are excluded.

The most common estimation methods:

Rule of nines (adults): each arm = 9%, each leg = 18%, anterior trunk = 18%, posterior trunk = 18%, head = 9%, perineum = 1%. Quick and usable at the bedside without charts.
Lund-Browder chart: more accurate, especially for children, because it adjusts head and leg percentages by age. Children have proportionally larger heads relative to body surface area.
Palmar method: the patient’s own palm plus fingers is approximately 1% TBSA, useful for estimating scattered or irregular burns.

Fluid of choice

Lactated Ringer’s (Hartmann’s) solution is specified by the Parkland formula for the first 24 hours — it is a balanced crystalloid that minimises the hyperchloraemic acidosis that large volumes of normal saline can cause. Colloids and blood products may be considered after the first 24 hours as capillary integrity begins to recover.

Worked example

Patient: 70 kg adult with 30% TBSA partial-thickness burns. Burns occurred 2 hours before hospital arrival.

total 24h = 4 × 70 × 30 = 8,400 mL
first 8h volume (from injury time) = 4,200 mL
  — only 6 hours remain, so rate = 4,200 ÷ 6 = 700 mL/hr
next 16h volume = 4,200 mL
  — rate = 4,200 ÷ 16 = 263 mL/hr

Note how the 2-hour pre-hospital delay compresses the first window and requires a higher initial rate. Without accounting for injury time, the rate would be calculated as 4,200 ÷ 8 = 525 mL/hr — too slow for the remaining window.

Titration endpoints

The Parkland volume is a starting point, not a fixed target. Titrate the infusion rate to physiological endpoints:

Adults: urine output of approximately 0.5 mL/kg/hr
Children: urine output of approximately 1 mL/kg/hr

Rates above these targets may indicate over-resuscitation; rates below, under-resuscitation. Hourly monitoring allows adjustment. The formula tends to overestimate requirements in very large burns (greater than approximately 50% TBSA), and some burn centres use modified starting volumes of 3 mL/kg/%TBSA (“modified Parkland”) or the Brooke formula in those cases.

This tool is a clinical decision support aid. It does not replace clinical judgement, local burn-centre protocols, or direct senior review. All calculations run in your browser.