نظرة سريرية عامة

The Parkland formula is a bedside decision-support calculation used to standardize a defined part of clinical assessment. It supplies an initial crystalloid estimate for major thermal burns, timed from injury rather than hospital arrival. The result should be interpreted with the patient’s presentation, baseline function, serial observations, laboratory method, medication exposure, and the protocol used by the treating institution. It is an aid to communication and risk stratification rather than an independent diagnosis or treatment order.

Enter contemporaneous values and confirm every unit before calculating. When physiology is changing, repeat assessment and prioritize the clinical trajectory over a single number. Document the input values alongside the result so another clinician can reproduce the calculation and recognize assumptions. Thresholds describe populations and do not remove the need to investigate discordant symptoms, examination findings, imaging, or biomarkers.

دواعي الاستخدام

• Initial adult crystalloid estimate for significant thermal burns
• Starting point followed by titration to physiologic response

القيود والسلامة

The formula is a starting point; inhalation injury, electrical injury, delayed presentation, children, pregnancy, and comorbidity can change requirements. Validation cohorts, case mix, prevalence, and treatment era affect observed event rates. Pregnancy, extremes of age or body composition, critical illness, and major comorbidity may reduce transportability unless specifically represented in the original model. Do not extrapolate beyond the stated population or substitute this estimate for a validated local pathway.

Before acting, check for missing data, measurement error, competing diagnoses, contraindications, and time-sensitive emergencies. A low-risk label never overrides clinician concern; a high-risk label does not prove the target condition. Discuss consequential decisions with the appropriate senior or specialty team and use current regional guidance.

• Do not count superficial epidermal burns in TBSA
• Electrical, inhalational, pediatric, delayed, or special-population burns need specialist protocols

المعادلة

24-hour crystalloid = 4 mL × weight (kg) × %TBSA; give half in first 8 hours from time of burn and half over next 16 hours

تفسير النتائج

• First 8 h — Early resuscitation: Half of calculated 24-hour volume. Subtract fluid already given; time from the burn.
• Next 16 h — Ongoing resuscitation: Remaining half. Titrate rate to endpoints rather than blindly completing volume.

المراجع

1. Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns.
2. American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation.

الأسئلة الشائعة

Does TBSA include first-degree burns?

No. Count partial- and full-thickness burns, not superficial erythema alone.

Does the clock start at hospital arrival?

No. The first eight-hour window starts at the time of burn.

Should the exact calculated volume always be given?

No. Titrate to clinical endpoints and specialist protocol to avoid under- or over-resuscitation.