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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
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    Chief Complaint


    Organ System


    Patent Pending

    Parkland Formula for Burns

    Calculates fluid requirements for burn patients in a 24-hour period.


    Use in adult patients with burns. Children have larger TBSA relative to weight and may require larger fluid volumes.
    When to Use
    Why Use

    Patients with acute burns.

    • The Parkland Formula is a validated and effective approach to initial fluid resuscitation in the acutely burned patient.
    • Overly aggressive fluid resuscitation, termed “fluid creep”, is well documented in critical care literature. Factors that may lead to fluid creep include lack of physician observation of endpoints (i.e. urine output), increased opioid use and the emergency nature of goal-directed resuscitation.
    • Patients with inhalational and electrical burns, as well as children and the elderly, may require more or less fluid resuscitation than is predicted by the formula.
    • The Parkland Formula has been endorsed by the American Burn Association.
    • It has been shown to appropriately restore intravascular volume and limit the development of hypovolemic shock.
    Rule of 9's for Adults: 9% for each arm, 18% for each leg, 9% for head,18% for front torso, 18% for back torso.
    Rule of 9's for Children: 9% for each arm, 14% for each leg, 18% for head, 18% for front torso, 18% for back torso.


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    Creator Insights


    It is important to remember that all resuscitation formulas be used as a guide. Patients should be assessed frequently, with individual adjustments made to maintain adequate organ perfusion.


    Resuscitation endpoints and monitoring:

    • Urine output: 0.5 mL/kg/hr urine output in adults (50-100cc/hr) and 0.5–1.0 mL/kg/hr in children <30 kg.
    • Heart rate: HR<110 in adults usually indicates adequate volume. Narrowed pulse pressure provides an earlier indication of shock than does systolic blood pressure alone.
    • Monitoring blood pressure by arterial catheter is superior to cuff pressures because of interference of tissue edema. Radial artery is the first choice, followed by femoral artery.
    • Serum lactate is a strong predictor of mortality, and trends can be utilized to determine hemostatic status however, it should not be used as an independent predictor of adequate fluid resuscitation.

    Critical Actions

    Critically ill burn patients are best cared for at a dedicated burn center, particularly those with any of the following:

    • >10% TBSA partial thickness burns
    • Any size full-thickness burn
    • Burns to hands or genitals
    • Inhalation injury
    • Serious chemical injury
    • Serious electrical injuries, including lightning
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    • David Zodda, MD
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    • David Zodda, MD