What is the Parkland formula for fluid resuscitation in burn victims?

• A. 2mL/kg x %BSA burned; first half over 12 hours
• B. 6mL/kg x %BSA burned; first half over 8 hours
• C. 4mL/kg x %BSA burned; first half over 8 hours, second half over 16 hours
• D. 1mL/kg x %BSA burned; first half over 4 hours

Answer: (C)

The essential idea is to replace fluid losses after a burn with a calculated, steady approach that matches the extent of injury. The Parkland formula uses 4 mL of Lactated Ringer’s solution per kilogram of body weight for each percent of total body surface area burned. Half of that total is given in the first 8 hours after the burn, and the remaining half over the next 16 hours. This regimen aims to prevent hypovolemia from the fluid shifts that occur in burn injuries.

For example, a 70 kg patient with 40% TBSA burns would need 4 × 70 × 40 = 11,200 mL in the first 24 hours. Half (5,600 mL) is delivered in the first 8 hours, and the other half (5,600 mL) over the subsequent 16 hours. Start timing from the moment of burn injury, not arrival to care. After initiating, adjust based on clinical targets like urine output (approximately 0.5 mL/kg/hour in adults) and overall perfusion. The fluid type used is Lactated Ringer’s, not normal saline.