A 35-year-old unrestrained male driver is brought in by paramedics following a motor vehicle collision (MVC). There was extensive passenger space intrusion and significant steering wheel deformity. On arrival to the emergency department, the patient is conscious and responsive. His blood pressure is 80/40 mmHg and heart rate is 110/min. His pupils are equal, round, and reactive to light. His breathing is shallow but he is able to protect his airway. Breath sounds are clear bilaterally. His abdomen is distended and mildly tender to palpation, without rebound or guarding. He has blood at the urethral meatus. There are no obvious deformities in his extremities.