• A J Lindford, P Lim, B Klass, S Mackey, B S Dheansa, and P M Gilbert.
• Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital, East Grinstead, UK. lindford@hotmail.com
• Emerg Med J. 2009 Apr 1;26(4):245-9.

BackgroundThere is considerable variation in the standard of initial burn management, particularly burn surface area assessment and application of resuscitation formulae. Early aggressive management of major burns improves survival. Internationally, the Parkland formula employing lactated Ringer's solution is used for fluid resuscitation. This study aimed to assess whether Parkland fluid resuscitation tables could improve the accuracy of initial fluid requirement calculations.MethodsThe burn size had first to be determined for an adult and a child using a preshaded Lund and Browder chart. Fluid requirements then had to be calculated using the conventional Parkland formula. The burn size had to be similarly calculated for two further cases and fluid requirements calculated using resuscitation tables. The study had a sample size of 50, consisting of plastic surgery trainees, anaesthetists and burn nurse specialists.ResultsAll the participants found the resuscitation tables to be quicker and easier to use. The burn size was correctly calculated in 72% of cases. Fluid resuscitation requirements were correct in only 55% when using the Parkland formula. The use of resuscitation tables improved the accuracy in calculating fluid requirements to 75%.ConclusionsThe use of Parkland fluid resuscitation tables can improve accuracy and ease of calculation of fluid resuscitation requirements.

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