A 72-year-old woman falls at home after an episode of dizziness. She had been complaining of low-back pain for 3 days before the fall. In the emergency department, she is hypotensive and has cold, clammy extremities. A pulsating mass is palpable on abdominal examination. Following resuscitation, the next step in the management should involve which of the following?

The presence of acute vascular collapse with history of abdominal or flank pain and associated pulsating abdominal mass is characteristic of a ruptured abdominal aneurysm. Operation should be performed as quickly as possible, because the first priority is to control the hemorrhage. No time should be lost in obtaining diagnostic studies, because these patients often crash in the radiology suite. These patients should not be resuscitated aggressively, because an increase in systolic pressure will only cause more intra-abdominal hemorrhage.