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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Surgery is reserved for those patients with internal bleeding where the bleeding cannot be controlled by less aggressive treatment or where the bleeding is causing damage because of its location. Some examples include the following:

• Neurosurgeons may operate to remove blood clots that are pressing on the brain (epidural or subdural hematomas) but depending upon the situation, the decision to observe the patient and watch them recover without surgery may be appropriate.
• When bleeding occurs in the abdomen, general surgeons may need to operate to find and repair the bleeding source. In some cases, interventional radiologists may work with a surgeon and using angiography, find the source of bleeding and repair it without performing surgery.
• Vascular surgeons are often called upon to repair major blood vessels that have leaked or ruptured. Patients with aortic aneurysms that have ruptured may need emergent life saving surgery, while those whose aneurysm have expanded but not ruptured may be candidates to have stents placed using angiography.
• When orthopedic surgeons repair fractures, it has an added benefit of decreasing the amount of bleeding from the fracture site and minimizing future blood loss.

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