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48-year-old Amish female transferred via lifeflight after an auto vs. buggy accident. The patient is intubated at the scene for a GCS 6. Her vitals on arrival are as follows: BP-84/50, HR 142, RR- 20 (bagged) and PO-100%. On examination, she has multiple bruises noted on her torso and extremities. Her pelvis is unstable and she has a closed right femur fracture. After initial stabilization you perform a FAST exam. The pericardial, perisplenic and pelvic windows were negative. On the perihepatic window you note the following......
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