Should I use 2 or 4 mL/kg/%TBSA?

The Parkland formula uses 4 mL/kg/%TBSA. The modified Brooke formula uses 2 mL/kg/%TBSA with colloid in the second 24 hours. For prehospital and initial resuscitation, 4 mL/kg/%TBSA (Parkland) with Hartmann's is the Australian and US standard.

What fluid should I use?

Hartmann's solution (Lactated Ringer's) is the recommended fluid for burns resuscitation. Normal saline (0.9% NaCl) causes hyperchloraemic acidosis and should not be used as the primary resuscitation fluid for major burns.

What if the patient is already 3 hours post-injury?

Subtract elapsed time from the 8-hour window. If 3 hours have elapsed, the first half must be given in 5 hours: divide first-half volume by 5 to get mL/hr. Never try to 'catch up' too aggressively.

Parkland Burns Formula — Free Paramedics Calculator

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House fire victim, 35% TBSA burns, 85 kg. First hospital is an hour away. You need to start fluids now and know what to titrate to.

Parkland Burns Formula

Burns

Patient weight (kg)

Imperial mode auto-converts lb→kg

TBSA burned (%)

Total body surface area — Rule of Nines

Total 24h = 4 mL × Weight (kg) × TBSA% First 8h = Total ÷ 2 · Next 16h = Total ÷ 2 Rule of Nines: Head 9% · Each arm 9% · Each leg 18% · Anterior trunk 18% · Posterior trunk 18% · Perineum 1%
Use Hartmann's (Lactated Ringer's). Time from injury, not hospital arrival.

💡 The Parkland formula typically applies to burns >15% TBSA in adults and >10% in children. Discuss volumes >50% TBSA with a burns unit.

Reference: Baxter CR — Parkland Formula (NCBI) · ATLS Burn Guidelines

⚕️ Clinical safety: 🇦🇺 Verify with facility drug formulary and senior clinician · Meets AHPRA/ACSQHC standards

1 What this calculator does

Calculates total 24-hour fluid resuscitation volume for burn patients using the Parkland formula. Outputs total volume, first 8-hour rate (from time of injury) and next 16-hour rate. Uses body surface area percentage and patient weight.

2 Formula & professional reasoning

Total fluid (mL) = 4 × Weight (kg) × TBSA burned (%)  |  Half given over first 8 hrs from injury, half over next 16 hrs

The Parkland formula was developed by Baxter and Shires in 1968. The 4 mL/kg/%TBSA formula estimates the crystalloid required to replace the massive fluid shift from intravascular to interstitial space in burn injury. Hartmann's (Lactated Ringer's) is preferred over normal saline. The 8-hour window starts from time of injury, not time of clinical contact — a critical distinction for pre-hospital and inter-hospital calculations.

3 Worked examples

⚠️ Illustrative example only — not clinical or professional instruction.

Basic

Small adult burn — 25% TBSA

Given: 75 kg, 25% TBSA

Working: 4 × 75 × 25 = 7,500 mL | First 8 hrs: 3,750 mL | Next 16 hrs: 3,750 mL

Answer: 7,500 mL total; 469 mL/hr first 8 hrs

💡 Adjust rate for time elapsed since injury. Urine output target 0.5–1 mL/kg/hr.

Standard

Moderate adult burn — 35% TBSA

Given: 85 kg, 35% TBSA

Working: 4 × 85 × 35 = 11,900 mL | First 8 hrs: 5,950 mL | Next 16 hrs: 5,950 mL

Answer: 11,900 mL total; 744 mL/hr first 8 hrs

💡 If 2 hours elapsed since injury, 6 hrs remain for first half → 5950 ÷ 6 = 992 mL/hr remaining rate.

Advanced

Paediatric burn — weight-based

Given: 20 kg child, 30% TBSA

Working: 4 × 20 × 30 = 2,400 mL | First 8 hrs: 1,200 mL | Next 16 hrs: 1,200 mL

Answer: 2,400 mL total; 150 mL/hr first 8 hrs

💡 Children also require maintenance fluids added (Holliday-Segar). Glucose 5% in Hartmann's recommended. Urine target 1 mL/kg/hr.

4 Sanity check

Time from injury

8-hour clock starts at INJURY TIME

If 2 hours have elapsed, only 6 hours remain to give the first half — increase the initial rate accordingly.

TBSA threshold

Resuscitate burns ≥20% TBSA in adults, ≥15% in children

Minor burns do not require Parkland resuscitation.

Urine output target

0.5–1 mL/kg/hr adults, 1 mL/kg/hr children

Urine output is the best real-time guide to adequacy of resuscitation.

Maximum TBSA

Cap at 50% TBSA for formula purposes

Above 50% the formula overestimates fluid requirements.

5 Common errors

Error	Cause	Consequence	Fix
Starting clock from clinical contact not injury time	Habit from other prehospital calculations	First half given over wrong time window — under-resuscitation in first hours	The 8-hour clock ALWAYS starts from time of injury. Subtract elapsed time to find remaining time for first half.
Including superficial (1st degree) burns in TBSA	Assessment includes redness not just blistering	Over-estimates TBSA and over-resuscitates	Exclude superficial erythema (1st degree) from TBSA calculation — only include partial and full thickness burns
Not adjusting for paediatric maintenance	Using adult formula only	Paediatric patient under-resuscitated overall	Children: add Holliday-Segar maintenance fluids to the Parkland volume — the calculator flags this
Using normal saline instead of Hartmann's	Default IV choice	Hyperchloraemic acidosis and worse outcomes	Burns resuscitation uses Hartmann's (Lactated Ringer's) solution — not normal saline