Parkland Burn Formula: How the Fluid Calculation Works

The Parkland formula estimates how much fluid an adult with a significant burn may need in the first 24 hours: 4 mL of lactated Ringer’s x body weight in kg x percent of total body surface area (%TBSA) burned. Half goes in over the first 8 hours after the burn, and the other half over the next 16 hours. It is a starting estimate, not a fixed order.

The formula

Total fluid for 24 hours (mL) = 4 mL x weight (kg) x %TBSA burned.

• Fluid type: lactated Ringer’s. The StatPearls article on the Parkland formula names it the preferred crystalloid, and large volumes of normal saline are typically avoided because they can cause hyperchloremic acidosis.
• Timing: half of the total in the first 8 hours, and the other half over the following 16 hours. The StatPearls article says the 24 hours are counted from the time of injury, not the time of provider evaluation. The MSD Manual says the same.
• %TBSA: only partial-thickness and full-thickness burns are counted. The StatPearls article states that all superficial burns are excluded.
• Children: the same article gives 3 mL per kg for children instead of 4 mL.
• Units: mL for volume, kg for weight, a whole-number percent for %TBSA, and mL/hr for the hourly rate.

Using it in NurseTools

The Parkland Burn Formula tool is in clinical review and is not available yet. It is locked in the app and will not be available at launch. NurseTools itself is coming soon to the App Store, and nothing is downloadable today.

The app shows a release-gates timeline: source and rights audit, clinical editorial review, independent testing, and regulatory and App Store review. A tool that has not passed all of these stays locked. No payment or setting unlocks a tool that has not passed review. You can turn on the “Notify me when available” switch to hear about it.

When the app is out, it will not need an account, will never ask for patient data and will work offline. Only the BMI and MAP tools are planned for launch.

Worked example

This is a made-up practice example, not a patient.

An adult weighs 70 kg. The burns are 30% partial thickness or deeper, plus 10% superficial.

1. Choose %TBSA. Superficial burns are not counted, so %TBSA = 30.
2. Total for 24 hours. 4 x 70 x 30 = 8,400 mL.
3. Split. Half is 4,200 mL for the first 8 hours after the burn. The other 4,200 mL goes over the next 16 hours.
4. First 8 hours, hourly rate. 4,200 / 8 = 525 mL/hr.
5. Next 16 hours, hourly rate. 4,200 / 16 = 262.5 mL/hr. Rounding to the nearest whole mL gives 263 mL/hr. Real pump settings follow facility policy.
6. Arrival time matters. Suppose the person arrives 2 hours after the burn and nothing has been given. The first-half volume still has to finish by hour 8 from the burn, which leaves 6 hours: 4,200 / 6 = 700 mL/hr.
7. Urine output check. An adult target of 0.5 to 1 mL/kg/hr is quoted in the StatPearls article. For 70 kg that is 0.5 x 70 = 35 mL/hr up to 1 x 70 = 70 mL/hr.

The rate in steps 4 to 6 would then be raised or lowered based on the urine output and the rest of the clinical picture.

Limits and common pitfalls

• Starting point only. The MSD Manual calls the formula only a starting point, and rates are adjusted to hourly urine output. A review of burn care also describes careful titration to urine output as the most important intervention.
• Wrong clock. Counting from arrival instead of from the burn is a common mistake.
• Wrong %TBSA. Including superficial burns inflates the total.
• Over-resuscitation. A review of burn resuscitation describes “fluid creep” and reports that 58% of patients in one study needed more fluid than the Parkland formula predicted, which is why titration matters.
• Other formulas exist. The modified Brooke formula uses 2 mL instead of 4 mL. The same review notes that American Burn Association (ABA) consensus describes a 2 to 4 mL/kg/%TBSA range for the first 24 hours, with an adult urine output target of 0.5 to 1.0 mL/kg/hr.
• Local protocols win. Facilities set their own burn protocols, so follow yours.