Burns Resuscitation Formulas
Burn Resuscitation Formulas & Calculator
🔥 Burn Fluid Calculator
Estimate 24-hour fluid needs using major resuscitation protocols.
📏 Rule of Nines: TBSA Estimation
| Body Area | Adult (%) | Child (%) |
|---|---|---|
| Head & Neck | 9% | 18% |
| Each Arm | 9% | 9% |
| Chest | 18% | 18% |
| Abdomen | 18% | 18% |
| Upper Back | 9% | 9% |
| Lower Back | 9% | 9% |
| Each Leg | 18% | 14% |
| Genitalia | 1% | 1% |
Note: Palm ≈ 1% TBSA for small burns.
| Formula | Fluid Type | Volume Calculation | Administration | Key Features | Max TBSA |
|---|---|---|---|---|---|
| Parkland / Baxter | Lactated Ringer’s (LR) | 4 mL × kg × %TBSA | 50% in 8h, 50% in 16h | Standard for adults; avoid colloids first 24h | None |
| Modified Brooke | LR | 2 mL × kg × %TBSA | 50% in 8h, 50% in 16h | Lower volume; less edema risk | None |
| Consensus | LR or balanced saline | 2–4 mL × kg × %TBSA | 50% in 8h, 50% in 16h | Flexible; adjust to urine output | None |
| Evans | Colloid + Saline + Glucose | 1 mL colloid + 1 mL saline × kg × %TBSA + 2000 mL D5W | 50% in 8h, 50% in 16h | Early colloids; cap TBSA at 50% | 50% |
| Galveston (Peds) | LR + 5% Dextrose | 5000 mL/m² × %TBSA + 2000 mL/m² maintenance | 50% in 8h, 50% in 16h | For children <30 kg; BSA-based | None |
| Hypertonic Saline | 3% NaCl | Titrate to urine output | Adjust hourly | Reduces edema; monitor Na⁺ closely | None |
| Rule of 10s | LR | TBSA (%) × 10 = mL/hr (assumes 80 kg) | Full in 8h, half in 16h | Field triage tool; rapid estimate | None |
| Shoemaker (Electrical) | LR + Bicarbonate | 6–9 mL × kg × %TBSA | Aggressive; urine goal 100 mL/hr | Prevents myoglobinuric renal failure | None |
| Toronto Formula | D5W + Plasma + Saline | 3 mL × kg × %TBSA + 2000 mL D5W | 50% in 8h, 50% in 16h | Historical; limited modern use | None |
💡 Key Clinical Notes
- Start time: Begin fluids from time of injury, not admission.
- Colloids: Avoid in first 12–24 hours (except Evans/Toronto).
- Pediatrics: Add maintenance fluids (e.g., Holliday-Segar method).
- Urine output: Target 0.5–1 mL/kg/hr (adults), 1 mL/kg/hr (children).
- Over-resuscitation: Common with TBSA > 50%; monitor for compartment syndrome.
- Electrical burns: Use Shoemaker formula with bicarbonate to prevent renal failure.
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