Nonvariceal upper gastrointestinal (GI) bleeding represents thousands of emergency room visits and hospitalizations annually, with an overall mortality rate of 5% to 10% despite advances in medical and endoscopic therapies (1). Endoscopy is the primary modality for accurate diagnosis and treatment of upper GI hemorrhage. The diagnostic accuracy of upper endoscopy is more than 95%. Aggressive initial resuscitation is essential for good patient outcomes and must be performed independent of the time to upper endoscopy. Dr Julia Liu is a gastroenterologist at the University of Alberta Hospital, Edmonton, Alberta