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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 ...

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. ▶
    Start

    Major Burn Injury

    >20% TBSA adult, >10% TBSA child

    1. ●
      Action

      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
      1. ●
        Action

        Parkland Formula

        4 mL × kg × %TBSA = 24h total

        • Give 50% in first 8 hours
        • Give 50% over next 16 hours
        • Use LR or crystalloid
        1. ◆
          Decision

          Urine Output Target

          • Adult: 0.5 mL/kg/hr
          • Child: 1.0 mL/kg/hr
          1. ●
            Action

            Low UOP: Increase Rate

            Increase by 25-50%

            1. ◆
              Decision

              Consider Colloid?

              If crystalloid >6mL/kg/%TBSA

              1. ●
                Action

                Add Albumin

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

              2. ■
                End

                Continue Crystalloid

                Titrate to UOP

          2. ●
            Action

            On Target: Continue

            Reassess hourly

          3. ●
            Action

            High UOP: Decrease Rate

            Decrease by 25%

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

Breast Reconstruction Timing Algorithm (NCCN/ASPS)

Management

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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