Parkland Formula

Imagine a little girl reaching up to a pot of boiling water and pulling it down on top of herself. Can you see the water splashing against her chest, running down the front of her stomach and her chest?

Imagine a little girl climbing into a bath or sink of hot water. How many limbs do you think she’d stick in on her own before crying out in pain and pulling it back out? Probably just one hand or one foot.

Now imagine someone picking her up and trying to drop her, facing down, in a sink or tub of scalding water. She would have no choice but to extend both arms and legs trying to protect herself. Her hands and legs would have burns circling the limbs, not like the splash of pulling a pot down on top of yourself. If she was able to get into a crouching position, pulling her knees in towards her chest, then perhaps the backs of her knees would be spared, but her buttocks would still be exposed to the hot water.

Imagine skin peeling off her limbs like sheets of thin wax. Like a snake shedding it’s skin, with a brand new, unproteced layer of bright pink painful tissue underneath.

I aksked everyone who was touching her to put on sterile gloves. The first 20 minutes was spent trying to get an IV started. I didn’t have luck, but eventually Mark, the RN did. I had our tech help me hold dressings in place while I wrapped gauze around and around her legs. Keeping the sterile dressings on her feet was the hard part. Once her burns were all covered, We gave her several warm blankets to prevent hypothermia. I grabbed a reference picture for pediatric burns and calculated the percentage body surface area. I scribbled down numbers and rates and calculated the Parkland formula. 125 ml per hour of fluids for her ride to the regional burn center an hour and a half away. The most perplexing part of it all was why wasn’t she crying?

I went to our cupboard of crochet animals made by a local church group as part of their outreach. I picked out a small, colorful bunny and placed it on her chest.

Next to a space labled Valuables on her transfer sheets I wrote “Stuffed Bunny, Binkie.”

  3 comments for “Parkland Formula

  1. J. Hubler
    May 12, 2008 at 5:09 am

    Imagine a little Cessna, carrying two men, dropping out of the sky and crashing into two homes in a development, causing two, fully involved structure fires within a fraction of a second. Imagine this tragic event happening at 7:45am, on a hot, mid-July weekday; families just waking up, making breakfast, getting ready for work; getting their kids ready for school or daycare… Imagine seeing a 10 year old boy jump out of his two story window with fames licking at his heels, landing on the cool, spongy grass… this boy you are picturing, walked down his driveway to sit on the side walk to wait for help… his mother came out through the front door, followed by the husband… who then began screaming where is she? Imagine seeing this man, already more than 75% of his body covered in 3rd degree burns walk back into the home to find the little girl who died that day under her window sill…

    imagine arriving on that scene- running to the little boy, wrapping his bleeding feet; covering him in burn sheets, putting an IO gun to his shin and pulling the trigger. And imagine this 10 year old boy, who we couldnt even get a regular IV on because of his severe 3rd degree burns covering over 93% of his little body, talking to you the entire time. Telling you how old he is, what his name is… and asking you about his little sister. He was on a chopper within ten minutes- at the most fifteen… he was still talking, the entire time.

    He wasnt crying. He was in pain- but it wasnt what was on his mind- that was obvious- he wasnt crying. he wasnt whining- the most he did to show he felt something was flinch every time someone messed with his IO or his feet…

    It is amazing what a child’s little body can go through- but what you have to anticipate it that drastic plunge into the worst case scenerio’s- kids decomp. so fast. So Fast.

    That little boy survived- he is still recovering at Schriner’s in Ohio- but he is through the worst part of the whole experience. His mother, who was 45% burned, survived and so did his step father, who was 95% burned after going back inside the home and having to be pulled out by an off duty fireman who lived on the other side of the block. Next door, there lived a family of four. The husband was at work, the 4yr old daughter was at grandma’s house. The 24y/o mother and the 6mo old baby boy were killed instantly, baby in mother’s arms.

    I personally was only a student, on my first EMT clinical with the FD Station who was first due. I look back on that day and have learned so much from it.

    I am now almost finished with my paramedic class- and I am working on a reseaqrch paper covering the Parkland Formula- I just thought I’d share a very personal and real life experience that not too many people see in their everyday lives.

    God Bless and Keep Doing What you are Doing

  2. Doc Shazam
    May 12, 2008 at 5:12 am

    Wow. THanks for sharing that story. Do you have your own blog?

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