REVIVE: Reducing Exsanguination Via In-Vivo Expandable Foam

Inclusion Criteria: 1. Estimated age of 15 years or older (or subject weight estimated at greater than 50 kg if age is unknown) 2. Emergent, exsanguinating hemorrhage, from abdominal source as defined by: * Class III or IV hemorrhagic shock or * Assessment of Blood Consumption (ABC) score ≥ 2 3. Confirmation of abdominal hemorrhage by: * Direct visualization or * Positive Focused Assessment with Sonography in Trauma (FAST) or * Diagnostic Peritoneal Aspiration (DPA) 4. No other known, uncontrolled active sources of hemorrhage 5. Subject is intubated and sedated per local guidelines 6. Decision to administer foam is made within 30 minutes of admission to the emergency department. 7. Decision made to proceed to emergent laparotomy made within 30 minutes of admission to the emergency department. 8. Definitive surgical care is expected to occur within three hours of foam deployment 9. Subject must also be receiving concurrent transfusion of fluids or blood products. Exclusion Criteria: 10. Known or suspected major diaphragm injury 11. Known or suspected untreated pneumothorax 12. Known or suspected untreated hemothorax 13. Known or suspected blunt or penetrating cardiac or thoracic aortic trauma 14. Traumatic brain injury resulting in decapitation, visible brain matter or considered non- survivable based on initial physical exam 15. Received greater than five consecutive minutes of cardiopulmonary resuscitation in the pre-emergency department setting 16. Patients with Pulseless Electrical Activity 17. Known allergy to isocyanate 18. Known or suspected pregnancy 19. History of prior abdominal surgery or evidence of abdominal surgery (scars) 20. Disrupted abdominal wall that, in the opinion of the investigator would preclude ResQFoam from being adequately contained within the abdominal cavity 21. Subject in whom the abdominal aortic junctional tourniquet (AAJT) or Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) techniques have been used 22. Known Prisoners 23. Subjects with burns \> 20% of total body surface area 24. Subject/legally authorized representative/subject family member purposefully opted out of participation in the study 25. Known Do Not Resuscitate order (DNR) or Physician Orders for Life Sustaining Treatment (POLST) 26. Known enrollment in another randomized, interventional study