The Parkland formula (Baxter, 1968 at Parkland Hospital, Dallas) remains the global default for the first 24 hours of burn resuscitation:

Volume = 4 mL × weight (kg) × %TBSA burnt

Half of the calculated volume is given over the first 8 hours from the time of the burn (not from the time of arrival), and the remaining half over the next 16 hours. Ringer's Lactate is the fluid of choice because it most closely matches serum electrolyte composition and avoids the chloride-load acidosis of normal saline.

• Rule of Nines (adult) — head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, perineum 1%
• Lund-Browder chart — most accurate, especially in children where head:body proportions differ (head can be 18% in an infant)
• Palmar method — patient's palm + fingers ≈ 1% TBSA, useful for scattered burns
• Exclude superficial (1°) burns — only count partial-thickness (2°) and full-thickness (3°)

• Inhalation injury — add 30–50% to calculated volume
• Electrical burns — deep tissue injury much larger than visible TBSA; target UOP 1–2 mL/kg/hr to flush myoglobin
• Delayed presentation — calculate as if from time of burn; deficit must be replaced
• Alcohol intoxication, methamphetamine — increased capillary leak

"Fluid creep" — over-resuscitation causing abdominal compartment syndrome — is the opposite hazard. Monitor bladder pressure every 4h in patients receiving >250 mL/kg in 24h.

India sees ~7 million burn injuries annually (NPB data), with kerosene stove flame burns dominating in women aged 15–35. Public burn centres (Safdarjung, AIIMS, KEM, CMC Vellore, NIMHANS) follow National Burns Programme protocols mandating Parkland on arrival, RL infusion, Foley catheter, and transfer if TBSA >20% or face/perineum involvement. Ringer's Lactate 500 mL costs ~₹40–60 in India; a typical 50% TBSA adult uses 14–20 L in 24h.