What is the Modified Brooke formula?

It estimates the first 24 hours of crystalloid resuscitation for a burn as 2 mL of Ringer's lactate per kilogram of body weight per percent of total body surface area burned. It deliberately uses about half the volume of the Parkland formula to reduce the risk of over-resuscitation.

How is the total split over time?

Half the calculated total is given over the first eight hours and the remaining half over the following sixteen hours. Crucially, the clock starts at the moment of injury, not at the time the patient reaches hospital.

How does it differ from the Parkland formula?

Parkland uses 4 mL per kilogram per percent burn, double the Modified Brooke volume. Both share the same 8-hour and 16-hour split. Modified Brooke is favoured by teams concerned about fluid creep and the complications of excessive resuscitation volumes.

Should I just follow the calculated number?

No. The formula gives a starting estimate only. Resuscitation must be titrated to physiological endpoints, principally urine output of roughly 0.5 mL per kilogram per hour in adults, and reassessed frequently as the picture evolves.

Does this replace specialist burns care?

No. It is an educational calculator. Major burns require referral to a burns centre, careful airway and analgesia management, and senior decision-making. Use this only as a cross-check within that framework.

Modified Brooke Formula — Burn Fluid Resuscitation

The Modified Brooke formula estimates the intravenous fluid a burn patient needs in the first 24 hours after injury. It uses a lower volume than the classic Parkland formula, reflecting modern concern about the harms of over-resuscitation, while keeping the same two-phase timing.

How it works

The total crystalloid volume is proportional to body weight and the extent of the burn:

total 24h = 2 mL x weight(kg) x %TBSA
first 8h  = total / 2
next 16h  = total / 2

The hourly rate for the first phase is the first-half volume divided by the hours remaining in the eight-hour window, which matters when resuscitation starts late because the clock runs from the time of the burn. The second-phase rate is simply the second-half volume divided by sixteen hours. The Parkland total, using 4 mL per kilogram per percent, is shown for comparison.

Notes and endpoints

Estimate the burned area carefully with the Rule of Nines or a Lund-Browder chart, counting partial and full thickness areas only. The calculated volume is a starting point, not a prescription: titrate the infusion to a urine output of about 0.5 mL per kilogram per hour in adults and reassess often. Major burns warrant early referral to a specialist burns service.