How to calculate Parkland Formula?

AliNajaCat · Nov 17, 2016

You know, you might post this on the Genersl Nursing forum, not the student forum, and get some real burn nurses to weigh in.

chare · Nov 17, 2016

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We are using this formula thought: 2mL x kg x % TBSA
We aren't using 4mL like our book indicates
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There are multiple formulae that can be used to calculate fluid replaced. The Parkland formula uses 4 mL/kg/%TBSA. The modified Brooke formula uses 2 mL/kg/%TBSA. Regardless of which formula is used, this is a starting point and the infusion rate should be titrated to maintain adequate urine output.

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2mL x 70kg x 60 = 8400mL to be infused in 24 hours
8400/2 = 4200 for the first 8 hours, and the other 4200 in the last 16 hours
4200/8 = 525mL/hr is the rate to be infused for the first 8 hours
4200/16 = 262.5mL/hr is the rate to be infused for the last 16 hours
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These are correct.

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Also, how do you calculate the missing hours? for example:
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When calculating delays, you still use the same percentages. Fifty percent of the calculated fluid replacement to be infused in the first 8 hours, based upon time of injury. The remaining 50% is infused in the 16 hour period beginning 8 hours post injury.

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38 year old female patient that weighs 90kg and has 40% third degree burns to her body arrives 3 hours late to the hospital.
2mL x 90 x 40 = 7200mL to be infused in 24 hours
7200/2 = 3600
Since she is 3 hours late, 8-3 = 5 hours left to infuse the first half
3600/5 = 720mL/hr (rate) for the first 5 hours (since we lost 3 hours)
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Correct.

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24-5 = 19 hours left for the second half to be infused
3600/19 = 189.4mL/hr (rate) for the last 19 hours (since we lost 3 hours, so we had 5 hours left for the first half and now have to infuse the rest in the last 19 hours to total out 24 hours)
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This is incorrect. The infusion rate is adjusted to allow 50% of the calculated volume to infuse in the 8 hour period post injury. The remaining 50% of the calculated volume is to be infused over the 16 hour period beginning 8 hours post injury.

And thank you for working the problems, not just posting the questions and waiting for someone to work them for you.

xmilkncookiesx, RN · Nov 17, 2016

Thank you for your help!!

So, for the last one I was incorrect on, is this how you do the delayed times? I'll repeat the example:

38 year old female patient weighs 90kg and has 40% third degree burns to her body arrives hours later to the hospital.

2mL x 90 x 40 = 7200

7200/2 = 3600

8-3 = 5 hours left

3600/5 = 720ml/hr for the first half

3600/16 = 225ml/hr for the second half

Did I do this correctly? Also, can you give me a tricky question for me to calculate, that I can practice with? I'd appreciate it

pmabraham, BSN, RN · Nov 17, 2016

Is your instructor telling you that you need to account for arriving late? We went over the the parkland formula in pediatrics, and we are to base our calculations from the time they arrived (not dealing with late or early). Now, we were told to deduct any fluid given pre-hospital from the first half that goes over 8 hours (prior to coming up with the mL/Hr rate), but we didn't have to worry about early/late.

Kuriin, BSN, RN · Nov 17, 2016

Our program, we were never taught delayed hours.

chare · Nov 17, 2016

Is your instructor telling you that you need to account for arriving late? We went over the the parkland formula in pediatrics, and we are to base our calculations from the time they arrived (not dealing with late or early)...

This is not correct. In both the Parkland and modified Brooke formulae, the first 24 hours fluid requirement, adult or pediatric, is based on time of injury, with 50% of the calculated volume being administered in the first 8 hours, from time of injury. And, the pediatric patient is likely going to have a much greater fluid requirement, as well as require a maintenance infusion of a dextrose containing fluid as well.

...Now, we were told to deduct any fluid given pre-hospital from the first half that goes over 8 hours (prior to coming up with the mL/Hr rate), but we didn't have to worry about early/late.

Yes, this is correct