Parkland formula

The Parkland formula, also known as Baxter formula, is a burn formula developed by Charles R. Baxter, used to estimate the amount of replacement fluid required for the first 24 hours in a burn patient so as to ensure the patient is hemodynamically stable.[1][2][3] The milliliter amount of fluid required for the first 24 hours – usually Lactated Ringer's – is four times the product of the body weight and the burn percentage (i.e. body surface area affected by burns).[4] The first half of the fluid is given within 8 hours from the burn incident, and the remaining over the next 16 hours. Only area covered by second-degree burns or greater is taken into consideration, as first-degree burns do not cause hemodynamically significant fluid shift to warrant fluid replacement.[5]

The Parkland formula is mathematically expressed as:[4]

${\displaystyle V=4\cdot m\cdot (A\cdot 100)}$

where mass (m) is in kilograms (kg), area (A) as a percentage of total body surface area, and volume (V) is in milliliters (mL). For example, a person weighing 75 kg with burns to 20% of his or her body surface area would require 4 x 75 x 20 = 6,000 mL of fluid replacement within 24 hours. The first half of this amount is delivered within 8 hours from the burn incident, and the remaining fluid is delivered in the next 16 hours.[6]

The burn percentage in adults can be estimated by applying the Wallace rule of nines (see total body surface area): 9% for each arm, 18% for each leg, 18% for the front of the torso, 18% for the back of the torso, and 9% for the head and 1% for the perineum.[7]