วิธีการคำนวณ Parkland Burn Formula
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The Parkland formula guides IV fluid resuscitation for burn patients in the first 24 hours using Lactated Ringer's. Half is given in the first 8 hours post-burn (not transfer).
สูตร
- Weight
- Body weight (kg)
- TBSA
- Total body surface area burned (Percentage (Rule of 9s))
- Fluid4Hrs
- Fluid in first 8 hours (mL)
- Fluid16Hrs
- Fluid in next 16 hours (mL)
คำแนะนำทีละขั้นตอน
- 1Total 24h = 4 mL × Weight(kg) × %TBSA burned
- 2First 8h from burn: 50% of total
- 3Next 16h: 50% of total
- 4TBSA = Total Body Surface Area burned
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What's the Rule of 9s for %TBSA?
Head/neck: 9%, Each arm: 9%, Chest: 18%, Abdomen: 18%, Each leg: 18%, Perineum: 1%. Measure by body part involvement. Children differ (head 18%, leg 14%).
Why Lactated Ringers (LR) vs normal saline?
LR isotonic, contains potassium, more physiologic. NS can cause hyperchloremic acidosis. LR preferred in burn resuscitation (evidence-based). Monitor urine output (goal 0.5 mL/kg/hr adults).
Is Parkland formula always enough?
Starting point; adjust based on clinical response. Goal: urine output 0.5 mL/kg/hr (1 mL/kg/hr if inhalation injury). May need more in lightning strike, electrical burns. Serial labs essential.
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