Abdominal Stab Wound with Bradycardia

You are working in a large hospital when you are called by a surgeon regarding a 51-year-old woman who is in the Emergency Department. She requires an urgent laparotomy following a single stab wound to the abdomen after an assault at home. Immediate history: Arrived to hospital via ambulance within 30 minutes of injury Since arrival to ED: · primary survey (no obvious other injuries) · IV access and blood tests taken · 1000 mL Normal Saline and analgesia administered · FAST scan reveals free air and fluid Observations: Airway patent. GCS 15 SpO2 95% on 6L/min oxygen via Hudson mask BP 80 mmHg systolic HR 38 bpm Dressing on anterior abdomen with some blood leaking through Medical History: Height – 153 cm Weight – 90 kg BMI 38.4 kg/m2 Type 2 diabetes mellitus, poorly compliant with prescribed treatment Mild chronic renal impairment Recent syncopal episodes and referred to cardiology – awaiting appointment Smoker – 20 cigarettes per day Medications: Perindopril 4 mg once daily Metformin 500 mg twice daily Glipizide 5 mg twice daily Atorvastatin 20 mg once daily Initial blood test results and a 12-lead ECG are displayed below.