Sandro Rizoli, MD PhD FRCSC FACS of both the Sunnybrook Health Sciences Centre and University of Toronto speaks on Massive Bleeding in Trauma at the 2012 annual Southwest Trauma & Acute Care Symposium. The main focus of a General Surgeon is to stop the patient from bleeding, which is the number one inhospital cause of death. Why can’t they stop bleeding? It is because they are coagulopathic, which means their blood will not clot appropriately. Why their blood will not clot is not fully known because of the complexity of coagulopathy. He also touches on the evidencedbased treatment, which is difficult because there is not sufficient evidence to support massive bleeding. However, the first step of treatment is to stop the bleeding before all else.