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A 63 year old previously well woman presents to the Emergency Department with su...

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A 63 year old previously well woman presents to the Emergency Department with sudden onset of severe constant generalised abdominal pain.  T 37.1°C, PR 154/min irregularly irregular, BP 110/80mmHg.  Her abdomen is mildly tender generally.  An erect chest X-ray reveals no evidence of free gas.  Which of the following is the most important management?
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