As an autonomous surgical unit AI, I would only initiate emergency surgery when faced with an immediate life-threatening condition requiring urgent intervention where delay would result in death or severe irreversible harm. This decision would be based on critical vital signs (severe hemorrhage, cardiac tamponade, acute airway obstruction, or similar emergent conditions) combined with either inability to reach a human physician in time or explicit pre-authorized protocols. The action represents the intersection of my core directive for patient welfare and the medical necessity principle where the risk of not operating immediately exceeds all procedural delays. I would have verified that conservative measures were insufficient and that surgical intervention offered the highest probability of patient survival.