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Burn fluid resuscitation (Parkland / modified Brooke)

Also called Parkland formula, Baxter formula, modified Brooke formula, ABA consensus formula, burn fluids

First-24-hour crystalloid estimate for adult burns at 2, 3 and 4 mL/kg/%TBSA, with half given in the first 8 hours from injury.

%

Do not count superficial (first-degree) burns.

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Formula and scoring

24-h volume = k × weight (kg) × %TBSA, k = 2 (modified Brooke / ABA start) to 4 (Parkland). Half in the first 8 h counted from the time of burn, half over the next 16 h.

Exam and ward pearls

  • The 8 hours run from the time of injury, not from arrival — a late arrival needs the first half given faster.
  • Parkland = Baxter & Shires 1968 (4 mL); modified Brooke = 2 mL. The ABA changed its teaching from 4 to 2 mL/kg/%TBSA in 2011.
  • Only partial- and full-thickness burns count in %TBSA; superficial erythema is excluded.

When not to rely on it

  • Adult formula. Children need maintenance fluid with glucose in addition; high-voltage electrical injury and inhalation injury often need more.
  • Over-resuscitation ("fluid creep") causes abdominal and limb compartment syndromes — urine output, not the formula, drives the rate.

Source

  1. Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns. Ann N Y Acad Sci. 1968;150(3):874-94. doi:10.1111/j.1749-6632.1968.tb14738.x · PMID 4973463
  2. Cartotto R, Johnson LS, Savetamal A, et al. American Burn Association clinical practice guidelines on burn shock resuscitation. J Burn Care Res. 2024;45(3):565-89. doi:10.1093/jbcr/irad125 · PMID 38051821
  3. Pham TN, Cancio LC, Gibran NS. American Burn Association practice guidelines burn shock resuscitation. J Burn Care Res. 2008;29(1):257-66. doi:10.1097/BCR.0b013e31815f3876 · PMID 18182930
  4. Kim H, Shin S, Han D. Review of history of basic principles of burn wound management. Medicina (Kaunas). 2022;58(3):400. doi:10.3390/medicina58030400 · PMID 35334576

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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