The patient exhibited signs of rapidly worsening hemodynamic instability with suspected ongoing internal hemorrhage and a positive bedside assessment consistent with free intraperitoneal fluid, while failing to respond adequately to aggressive resuscitation. Given the immediate risk of decompensation and potential cardiac arrest, delaying for additional diagnostics would have unacceptably increased mortality risk. Emergency consent protocols were applied due to incapacity and imminent threat to life, and the OR, anesthesia, and blood bank were mobilized with massive transfusion protocol prepared. The anticipated benefits of prompt operative hemorrhage control and source management outweighed the procedural risks, and team coordination and security measures were implemented to maintain patient and facility safety.