We present a case of a 3-year-old male with history of minor trauma, who was brought in by ambulance from the playground where he had an acute mental status change and was noted to be hypotensive on initial evaluation. History and examination did not indicate a clear etiology of his symptoms. Point-of-care emergency ultrasonography revealed free fluid in the abdomen and expedited the care of the child's unexpected intra-abdominal hemorrhage from an occult abdominal tumor. This case demonstrates the ability of practitioners to expedite and focus care with the use of rapid assessment with ultrasonography in the pediatric emergency department.