The Parkland formula is a medical calculation used to determine the fluid requirements for burn patients. This formula is critical in managing the fluid resuscitation of patients who have suffered from severe burns.
When is Parkland Formula used?
The Parkland formula is used in the initial management of burns, especially in patients with more than 20% of total body surface area (TBSA) burned.
It helps determine the amount of fluid a patient needs within the first 24 hours of injury.
How is Parkland Formula calculated?
The formula is based on the patient’s weight, the burn’s extent, and the fluid type used for resuscitation.
The standard Parkland formula for fluid resuscitation is 4 ml X body weight in kg X % TBSA burned.
This means that a patient should receive 4 millilitres of fluid per kilogram of body weight for every 1% of TBSA burned.
How are fluids given in the first 24 hours?
The first 8 hours are crucial; the goal is to restore tissue perfusion and prevent shock. The patient should receive half of the total fluid volume during this period.
The remaining half should be given in the next 16 hours.
The fluids given should be isotonic, such as lactated Ringer’s solution or normal saline, and should be titrated to maintain adequate urine output
For example, if a patient weighs 70 kilograms and has 30% TBSA burned, the calculation would be:
4 ml x 70 kg x 30% = 8,400 ml or 8.4 litres of fluid over 24 hours.
Half of the total fluid volume, which is 4.2 litres, should be given in the first 8 hours.
While the remaining half, which is 4.2 litres, should be given in the remaining 16 hours.
How is total body surface area calculated in burn patients?
Total body surface area is calculated using the Rule of Nines or the Lund and Browder chart.
The Rule of Nines divides the body into nine areas, each accounting for 9% of the total body surface area.
The Lund and Browder chart is more accurate and divides the body into smaller areas, with varying percentages based on age.
Take home
The Parkland formula is a lifesaving calculation used in the management of burn patients.
The goal is to provide adequate fluid resuscitation to prevent hypovolemic shock and maintain tissue perfusion.
The calculation is based on the patient’s weight, the burn’s extent, and the fluid type used for resuscitation.
