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Early Surgical Intervention to externally fixate is recommended and improves morbidity and mortality. Quality training should be conducted regularly in the application of surgical external fixation. This study recommends Boluses of 250?ml normal saline should be titrated until restoration of the radial pulse.These principles are supported by the National Institute for Health and Clinical Excellence in the guideline Pre?hospital initiation of fluid replacement therapy in trauma. New research supporting permissive hypotension, transfusions protocols and management of major trauma is, as expected, the way to go.

Blogger, student, sushi lover; but most of all, infatuated with pre-hospital and emergency medicine! You may use the images on this page as an aid for validating Washington state driver licenses and ID cards. Not applicable.Temporary driver licenses issued with the old design (before July 2010) have expired. The new design was part of our efforts to protect Washington residents from identity theft, and prevent photo swapping, tampering, and other types of license fraud.

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