Resuscitation Fluids in Burns

The modified Parkland formula gives a starting point for the first 24 hours of  fluid therapy in significant burns, however ongoing rates and types of fluid may vary depending on the clinical state of the patient.

Enter weight (kg):

 Resuscitation fluids are recommended if the TBSA* is >10% in children or >15% in adults.

 The resuscitation fluid requirement is calculated from the time of the burn, not the time of presentation. 

A minimum urine output of 0.5-1ml/kg/hr (1-2ml/kg/hr in young children) is the aim.
If this is not achieved, the hourly fluid rate may need to be increased (e.g. by 30% initially).

*TBSA = Total burn surface area (see below for how to estimate)
Enter TBSA* (%):
Time since burn (hr):
Fluid already given (ml):
Delayed presentation, dehydrated
or electrical/inhalation injury?

Fluid replacement

Type Fluid For first 8hr For next 16hr Total in 24hr
Replacement Hartmann's       
Maintenance e.g. 0.9% Saline + 5% glucose      
Total        

Estimating the Total Burn Surface Area (TBSA)
Ignore superficial erythema and use any of the methods below:

Rule of Nines  Lund & Browder Chart  Palm + Fingers Method

Child: For every year of age >1yr up to 10yr, decrease head surface area by 1% and increase each leg by 0.5%
Age 0yr 1yr 5yr 10yr 15yr Adult
A 9.5 8.5 6.5 5.5 4.5 3.5
B 2.75 3.25 4 4.5 4.5 4.75
C 2.5 2.5 2.75 3 3.25 3.5

Palm and fingers of the patient's hand = 1% TBSA
Adapted from NSW Health's Burn Transfer Guidelines - NSW Severe Burn Injury Service 2nd Ed. July 2008
Version 1.2 ©2011 A.M.Bonsall.