Parkland Formula for Burns Fluid Resuscitation
Calculates the volume of IV fluid (Hartmann's/Ringer's lactate) required in the first 24 hours of a major burn. Half given in the first 8h post-burn; remainder over next 16h.
Score interpretation
Total 24h Parkland volume < 4 L. Moderate burn resuscitation.
→ IV Hartmann's/Ringer's lactate. First half over hours 1–8 post-burn (not from time of presentation). Second half over hours 9–24. Titrate to urine output 0.5–1 mL/kg/h. Monitor for over-resuscitation (abdominal compartment syndrome).
Total 24h Parkland volume 4–9 L. Significant burn resuscitation required.
→ Burns unit transfer. IV Hartmann's as calculated. Hourly urine output monitoring (aim 0.5–1 mL/kg/h). NG feeding within 6h. Escharotomy if circumferential burns. Senior burn surgery input.
Total 24h Parkland volume > 9 L. Major burn — risk of massive fluid shifts and complications.
→ Immediate major burns centre transfer (if > 15% TBSA or special areas: face, hands, genitalia, perineum, circumferential). Airway assessment and early intubation if inhalation injury. Target UO 0.5–1 mL/kg/h. Monitor for abdominal compartment syndrome, pulmonary oedema. Colloid after 8–12h.
Interpretation bands for the Parkland Formula. Apply clinical judgement and local guidance.
References
- Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns. Ann N Y Acad Sci. 1968;150(3):874–894.
- National Burn Care Review. Standards and Strategy for Burn Care, A Review of Burn Care in the British Isles. NBCR, 2001.
Related
Curated clinical cross-links plus same-class fallbacks.
- Potassium chloride with calcium chloride sodium chloride and sodium lactate · Balanced crystalloid IV fluid
- Potassium chloride with calcium chloride and sodium chloride · Crystalloid IV fluid
- Lipid Emulsion 20% (Intralipid) · Antidote / Resuscitation
- Lipid Emulsion 20% (Intralipid) · Antidote / Resuscitation
- Potassium chloride with glucose · IV fluid (potassium + dextrose)
- Potassium chloride with glucose and sodium chloride · IV fluid (mixed)
- Major Trauma — Primary Survey (ATLS) · ATLS 10th Edition; JRCALC; NICE NG39
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Hypertrophic Pyloric Stenosis · BAPS / RCPCH
Featured in these MRCEM clinical pathways
The Parkland Formula is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.