In this episode of The Erik and Matt Show (EMS), Erik and Matt tackle one of the most common and potentially deadly emergencies in prehospital medicine: gastrointestinal bleeding. They break down the differences between upper and lower GI bleeds, what coffee ground emesis, bright red hematemesis, melena, and hematochezia each tell you about the source and severity of the bleed, and how to make critical treatment decisions in the back of the ambulance. They also cover why TXA is no longer indicated for GI bleeds, when blood transfusion is appropriate using the shock index, and how simple interventions like leg elevation can buy you time when you do not carry blood on your unit.