The Parkland Formula

[Francesco]

We had a liaison from a nearby trauma center give a class to our department about fluid resuscitation for burn patients. He reported that patients were consistently arriving at the center having received too much fluid as a result of medics not using the parkland formula. This being the case the trauma center was recommending that burn patients receive no more than a 500ml fluid bolus in the field. Though not the point of this post, I disagree with their recommendation. Promoting poorer patient care (lessor of two evils) rather than promoting optimal care just seems wrong.

After the class was over I approached the instructor/liaison, who was representing the trauma center, and asked him if he had ever seen a mobile app for the parkland formula that would give you drops/minute. He replied that he had not and when I showed him the one that I found on the android market he about fell over. It is a cool little app and I've checked the math and it appears to be spot on. I believe they now have it available for the IPhone also. Anyway.......thought it was an impressive (and quick) little app and wanted to share it with anyone who might be interested. If you are interested just do a search for "parkland formula", I think the company or developer is called "draken".

[Arctickat]

Sounds kinda scammy, check out the "company" website.

http://www.drakendesign.com/

If the OP actually has the software, he wouldn't have to "think" who the developer is at all, it would be clearly identified on the software.

Having said that, I might have considered d/l it to see what it's like if I had a smart phone.

Edited May 4, 2012 by Arctickat

[Francesco]

I only "thought" who the developer was since I didn't have my phone sitting next to me while posting. Didn't think it would be hard to find since it is the first app that pops up when you do a search for "parkland formula". However, since you don't have a smart phone, you probably don't have much or any experience with the android market. Also, after reading your reply, I sent an email to Draken Design via their link on the app description. I got a prompt reply that ended up in a really nice phone conversation with Frank (great name BTW) who is the co-founder of the company. He said their website was still under development as they have been really busy with re-writing code for a number of their apps and are getting ready to launch their "Custom Paramedic Formulary" for IPhone. Apparently they will put any department's formulary in a quick reference app (and visually appealing too--see their screen shots). This is a great idea, I'm going to see if I can get our department's formulary on their list.

Anyway.....be skeptical if you want but I think their Parkland Formula app is pretty slick. I also want to say thank you for your skepticism because without it I would never made contact with this developer and found out that our department could have our formulary put in an awesome looking app.

[Arctickat]

You're welcome Frank.

[chbare]

There are several applications that do this task. I use one called iResQ that calculates BSA based on a point and touch diagramme. In addition, it has ventilator, ABG, medication, lab and specialty critical care references. I imagine there exist several other capable applications out there.

[Francesco]

I have also seen several applications for the parkland formula but I hadn't seen one that would break it down to gtts/min. Seems like most give you the 24hr and/or 8hr. Not that it's hard to figure drops per minute from these numbers, I just thought it was neat not to have to. Does the IResQ give drops per minute?

[mobey]

Does the IResQ give drops per minute?

Does not matter if it does, we have 10,15,20,60 drop sets.

App's are very useful tools, but I am not interested in one micromanaging me. I enjoy the science of medicine, and I see apps like this "dumbing it down" for me. I am not saying it is not useful, and I am sure there are lots of non-science nerds *cough FF's* who are more interested in an easy out than actually doing math and building strategies in patient management, but that is just not me.

Good luck with you're app though!

[Arctickat]

My IV pump gives me ml/hr. gtts/min is essentially useless to me.

[Francesco]

This is some of the goofiest stuff I've ever heard.

[chbare]

No it does not. It is a critical care application and assumes a rudimentary level of quantitative literacy. It is quite simple to plug your volume to infuse, time and drop factor into one of the fundamental infusion formulae that we all learn.

Mobey, I agree somewhat; however, I have had to deal with some critical patients who were receiving multiple infusions and being managed on multiple, complex modalities such as unconventional ventilator strategies, invasive haemodynamic monitoring and balloon pumps. A reliable guide is a great way to double check yourself and prevent mixing, dosing and administration errors. I can prove dy/dx of y=x^3 is 3x^2 all day long, but deprive me of sleep and give me a train wreck of a patient and I will be double checking myself.