Review Question - QID 210419

A 45-year-old homeless man is brought to the emergency department. He was found unconscious at the park. The patient has a medical history of IV drug abuse, hepatitis C, alcohol abuse, schizophrenia, and depression. He does not receive normal medical follow-up or care. His temperature is 102°F (38.9°C), blood pressure is 137/88 mmHg, pulse is 90/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical exam demonstrates a diffusely distended abdomen that is dull to percussion with a notable fluid wave. Cardiac and pulmonary exam are within normal limits. The patient responds to painful stimuli and smells heavily of alcohol. Which of the following is the most appropriate next step in management?