A case of blunt trauma is brought to the emergency, in a state of shock; he is not responding to IV crystalloids; next step in his management would be:
A patient not responding to fluids is likely to have a continuous source of bleeding. An exploratory laparotomy to identify the source & appropriate management of the same, would be the best next step. Ref: CSDT, 11th Edition, Pages 252, 249.
Immediate laparotomy
Blood transfusion
Albumin transfusion
Abdominal compression