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. 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).
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
A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur mainl ...
do not cause hemodynamically significant fluid shift to warrant fluid replacement.
The Parkland formula is mathematically expressed as:
:
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.
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
The torso or trunk is an anatomical term for the central part, or the core, of the body of many animals (including humans), from which the head, neck, limbs, tail and other appendages extend. The tetrapod torso — including that of a hu ...
, 18% for the back of the torso, and 9% for the head and 1% for the
perineum.
See also
*
Charles R. Baxter
*
Parkland Memorial Hospital
References
{{reflist
Further reading
Parkland formula calculatorfrom
MDCalc
Diagnostic emergency medicine
Intravenous fluids