Parkland formula

IV fluid resuscitation is often necessary in significant (>20% BSA) second-or third-degree burns in adults and >10% BSA in pediatric patients, fluid resuscitation should be initiated in all infants with burns of >10-15%. Lac-tated Ringer s is a common fluid for burn resuscitation. The Parkland formula guides initial fluid resuscitation in the first 24 h. 

There are multiple formulas that can he used to fluid-resuscitate a burn patient. The Parkland formula is well established and commonly used. Before calculation can be done, it is necessary to determine the patient s weight (in kilograms) and correctly estimate the percentage TBSA burned. A good estimation tool for use in the field is the Rule of Nines (Figure 12.1). Because of their disproportionately large heads, children under 30 kg require an adjusted approximation of percentage TBSA. A child s entire head represents 18 % of the TBSA, and each lower extremity represents 14% of the TBSA. 

Electrical injuries often require more extensive IV fluid resuscifafion fhan calculated by the Parkland formula because the extent of subcutaneous and deep tissue involvement is usually underestimated by the apparent cutaneous injury. A sample of fhe pafient s urine should be obtained initially and kept for comparison to subsequent samples to assess clearing of fhe pigment. 

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