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Parkland Formula

Estimate crystalloid (lactated Ringer's) fluid requirements for the first 24 hours after a major burn injury.

Inputs

Body weight (kg)

%TBSA burned (2nd + 3rd degree) Percent total body surface area — 2nd and 3rd degree burns only. Use Rule of Nines or Lund-Browder chart.

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Enter weight and %TBSA above.

First 8 hours—

Next 16 hours—

Rate — first 8 hours—

Rate — next 16 hours—

⚠ Important: The Parkland formula is a starting estimate only. Titrate fluids to clinical endpoints: urine output 0.5–1 mL/kg/hr in adults (1 mL/kg/hr in children). Time starts from the time of burn, not arrival. Subtract any fluids already given.

Formula

Total 24h fluids = 4 mL × body weight (kg) × %TBSA burned
First 8 hours: Give 50% of total (from time of burn)
Next 16 hours: Give remaining 50%
Fluid: Lactated Ringer's (preferred crystalloid)

Rule of Nines (adult)

Head & neck: 9%
Each upper limb: 9%
Anterior trunk: 18%
Posterior trunk: 18%
Each lower limb: 18%
Perineum: 1%
Patient's palm (including fingers) ≈ 1% TBSA

Clinical pearls

Only count 2nd and 3rd degree burns — first-degree burns are excluded.
Titrate to urine output, not formula alone. Over-resuscitation causes edema, compartment syndrome, ARDS.
Children: consider adding maintenance fluids with dextrose (Parkland alone may cause hypoglycemia).
Inhalation injury: may require 30–40% more fluid than calculated.
Electrical burns: may need more fluid than %TBSA suggests due to hidden tissue damage.
Consider early transfer to a burn center for burns > 20% TBSA, full-thickness burns, or involvement of face/hands/feet/genitalia/joints.

References

Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns. Ann N Y Acad Sci. 1968;150(3):874–894.
ISBI Practice Guidelines for Burn Care. Burns. 2016;42(5):953–1021.
ABA Burn Center Referral Criteria.