A 29-year-old man is brought to the emergency department after being involved in a motor vehicle accident. The patient’s temperature is 36.8°C (98.2°F), pulse rate is 120/min, blood pressure is 80/45 mm Hg, and respiratory rate is 20/min, and oxygen saturation 97% on 2L nasal cannula. The patient is somnolent and responds only to painful stimuli. His skin is cold and clammy. A quick trauma survey reveals minor abrasions and contusions to his face and upper extremities. His neck veins are flat. His abdomen is dull to percussion and distended and there are several large hematomas.
Q: What is the next step in management?
A. Chest/abdomen CT scan
B. Two large bore peripheral IV access
C. Exploratory laparotomy
D. Abdominal ultrasound
E. Chest x-ray
Post your answer in the comments if you think you've got it ;-)
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