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Plastic SurgeryManagement

Burn Resuscitation (Parkland Formula / ABA Guidelines)

Burn Resuscitation (Parkland Formula / ABA Guidelines): Major Burn Injury → Calculate TBSA → Parkland Formula → Urine Output Target → Low UOP: Increase ...

Pathway Overview

10 steps

Algorithm Steps

10 total

  1. 01Start

    Major Burn Injury

    >20% TBSA adult, >10% TBSA child

  2. 02Action

    Calculate TBSA

    Rule of 9s or Lund-Browder chart

    • Adult: Head 9%, each arm 9%, each leg 18%, trunk 36%
    • Palm = 1% TBSA
    • Exclude 1st degree burns
  3. 03Action

    Parkland Formula

    4 mL × kg × %TBSA = 24h total

    • Give 50% in first 8 hours
    • Give 50% over next 16 hours
    • Use LR or crystalloid
  4. 04Decision

    Urine Output Target

    • Adult: 0.5 mL/kg/hr
    • Child: 1.0 mL/kg/hr
  5. 05Action

    Low UOP: Increase Rate

    Increase by 25-50%

  6. 06Decision

    Consider Colloid?

    If crystalloid >6mL/kg/%TBSA

  7. 07Action

    Add Albumin

    5% albumin 0.3-0.5 mL/kg/%TBSA

  8. 08End

    Continue Crystalloid

    Titrate to UOP

  9. 09Action

    On Target: Continue

    Reassess hourly

  10. Path rejoins step 06Shared downstream outcome
  11. 10Action

    High UOP: Decrease Rate

    Decrease by 25%

  12. Path rejoins step 06Shared downstream outcome

Guideline Source

American Burn Association Practice Guidelines for Burn Shock Resuscitation

DOI: 10.1093/jbcr/irx016View Guideline

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Parkland formula is a starting point - requires titration
  • May need modification for inhalation injury
  • Pediatric patients may require modified calculations
  • Electrical burns may need higher fluid volumes

Applicable Regions

USAUUKEU

AU: ANZBA guidelines

UK: ANZBA similar approach

US: ABA Parkland formula standard

Version 1Next review: 2028-01-01

Related Plastic Surgery Pathways

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Burn Center Transfer Criteria (ABA)

Diagnostic

Burn Depth Assessment Algorithm

Diagnostic

Degloving Injury Management

Emergency

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Frequently Asked Questions

What is the Burn Resuscitation (Parkland Formula / ABA Guidelines)?

The Burn Resuscitation (Parkland Formula / ABA Guidelines) is a management clinical algorithm for Plastic Surgery. It provides a structured decision tree to guide clinical decision-making, based on American Burn Association Practice Guidelines for Burn Shock Resuscitation.

What guideline is the Burn Resuscitation (Parkland Formula / ABA Guidelines) based on?

This algorithm is based on American Burn Association Practice Guidelines for Burn Shock Resuscitation (DOI: 10.1093/jbcr/irx016).

What are the limitations of the Burn Resuscitation (Parkland Formula / ABA Guidelines)?

Known limitations include: Parkland formula is a starting point - requires titration; May need modification for inhalation injury; Pediatric patients may require modified calculations; Electrical burns may need higher fluid volumes. Individual patient factors may require deviation from these recommendations.

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