A 68-year-old female presents to the ED with abdominal pain, bloating, and nausea which she states began this morning upon wakening about 3 hours prior to arrival. She appears moderately uncomfortable and pale. She is urgently brought to an acute care room and evaluated by the resident physician. Her initial vital signs reveal tachycardia of 120 beats/minute, blood pressure of 103/52, oxygen saturation of 90% room air, respiratory rate of 24 breaths/minute, and an oral temperature of 99.0° F. Prior medical history includes hypertension and hypercholesterolemia, and she has a surgical history of two caesarean sections, bilateral tubal ligation, and open cholecystectomy.

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