# Parkland Formula Calculator

Calculate IV fluid resuscitation for burn patients using the Parkland formula. Determine 24-hour fluid needs, hourly rates, and LR bag requirements.

## What this calculates

Calculate initial fluid resuscitation requirements for burn patients using the Parkland (Baxter) formula. This is the most widely used formula for estimating crystalloid fluid needs in the first 24 hours after a significant thermal burn injury.

## Inputs

- **Body Weight** (kg) — min 3, max 200 — Patient body weight
- **Burn Percentage (% TBSA)** (%) — min 1, max 100 — Total body surface area burned (2nd and 3rd degree burns only)

## Outputs

- **Total 24-Hour Fluid** (mL) — Total crystalloid fluid needed in the first 24 hours
- **First 8-Hour Rate** (mL/hr) — IV fluid rate for the first 8 hours post-burn
- **Next 16-Hour Rate** (mL/hr) — IV fluid rate for hours 8-24 post-burn
- **Lactated Ringer's Bags** — Estimated number of 1000 mL LR bags needed
- **Clinical Note** — formatted as text — Important clinical considerations

## Details

The Parkland formula, developed by Dr. Charles Baxter at Parkland Memorial Hospital in Dallas, calculates the total crystalloid fluid (Lactated Ringer's solution) needed in the first 24 hours post-burn: Total Volume = 4 mL x body weight (kg) x % total body surface area (TBSA) burned. Only second-degree (partial thickness) and third-degree (full thickness) burns are included in the TBSA calculation.

The calculated volume is administered in two phases: 50% of the total is given in the first 8 hours after the burn injury, and the remaining 50% over the following 16 hours. Critically, the 8-hour clock starts from the time of the burn injury, not from the time the patient arrives at the hospital. Fluid already given by EMS or in the emergency department counts toward the first 8-hour requirement.

IMPORTANT DISCLAIMER: This calculator is for educational purposes only. Burn resuscitation is complex and must be managed by trained medical professionals. The Parkland formula provides only a starting estimate. Actual fluid administration must be continuously titrated based on urine output, vital signs, and clinical assessment. Over-resuscitation can cause pulmonary edema, abdominal compartment syndrome, and other complications.

## Frequently Asked Questions

**Q: How is burn percentage (TBSA) estimated?**

A: The most common method is the Rule of Nines: head 9%, each arm 9%, anterior trunk 18%, posterior trunk 18%, each leg 18%, perineum 1%. For children, the Lund-Browder chart is more accurate as it adjusts for different body proportions. For scattered or irregular burns, the patient's palm (including fingers) represents approximately 1% of TBSA. Only second and third-degree burns are counted; superficial (first-degree) burns are excluded.

**Q: Why is Lactated Ringer's preferred over normal saline?**

A: Lactated Ringer's is the preferred crystalloid for burn resuscitation because its composition more closely resembles plasma. It contains sodium, potassium, calcium, and lactate (which is converted to bicarbonate by the liver), helping to avoid the hyperchloremic metabolic acidosis that can occur with large volumes of normal saline (0.9% NaCl). The pH of LR (6.5) is also closer to physiologic pH than NS (5.0).

**Q: What is fluid creep in burn resuscitation?**

A: Fluid creep refers to the tendency to administer significantly more fluid than the Parkland formula predicts, often 2-3 times the calculated amount. This over-resuscitation can lead to serious complications including pulmonary edema, abdominal compartment syndrome, extremity compartment syndrome, and cerebral edema. Modern burn centers emphasize goal-directed resuscitation, titrating fluids to maintain urine output of 0.5-1.0 mL/kg/hour rather than rigidly following the formula.

**Q: When should colloids be added to burn resuscitation?**

A: Colloids (typically 5% albumin) are generally introduced 12-24 hours after the burn injury, once capillary permeability begins to normalize. During the initial resuscitation period, capillaries are excessively leaky and colloids would simply extravasate into the tissues, providing no oncotic benefit. The Modified Brooke formula incorporates colloids at 0.3-0.5 mL/kg/%TBSA starting in the second 24 hours.

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Source: https://vastcalc.com/calculators/health/parkland-formula
Category: Health & Fitness
Last updated: 2026-04-21