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It is essential that, regardless of the dispatch determinant, EMS crews approach each patient in the same manner [2, 4]. Field personnel should acquire a history with unbiased technique by using effective communication strategies. A balance of both subjective and open‐ended questions (e.g., “Can you describe your pain for me?”) and objective and close‐ended questions (e.g., “Is the pain sharp?”) should be used. In fact, throughout all disciplines of health care, traditional dictums state that effective history taking can lead to an accurate diagnosis in the majority of cases.

Three possible outcomes can result from taking the history of a patient dispatched with an undifferentiated dispatch code. First, the EMS clinician may identify a prehospital diagnosis related to one of the chief complaint conditions listed among the non‐priority symptoms in common dispatch algorithms [3]. It is important that the clinician does not trivialize the patient’s needs in the absence of priority symptoms, as each patient defines their own emergency. Second, the EMS clinician may establish a prehospital diagnosis that is accurate but not one of the chief complaint conditions. In these situations, EMS personnel must coordinate their prehospital care knowledge to care effectively for the patient’s needs. Third, perhaps the most frustrating, EMS clinicians may be unable to identify the specific chief complaint. This last outcome may be the first indication that the patient truly has an undifferentiated condition. At this point, it is important for the EMS clinicians to optimize the clinician–patient interaction, while minimizing the time to treatment and time to transport.

The following strategies can be used to improve diagnostic accuracy during history taking [7, 9–11].

 Collect information to confirm or exclude life‐threatening conditions first; then focus on the most likely diagnosis.

 Reaffirm that there are no high‐priority symptoms affecting the patient’s ability to provide accurate answers, such as hypoglycemia or receptive and expressive aphasia from a stroke.

 Ensure that the patient is oriented to person, place, and time, and that there is no underlying cognitive impairment due to drug ingestion, delirium, dementia, etc.

 Where feasible, sit at the patient’s side to collect a thorough history.

 Use adjuncts to facilitate the history taking (e.g., drawing diagrams or using other visual aids).

 Optimize communication so that the patient clearly understands the language and questions (e.g., asking simple questions).

 Obtain collateral information from the next of kin, friends, or bystanders.

 Allow a few moments of uninterrupted time to mentally process each patient.

 Generate “most life‐threatening” and “most likely” diagnostic hypotheses.

 Mentally process one patient at a time.

 Avoid decision making when overly stressed or angry; take time out, regroup, and reevaluate the decision.

 Move on to physical examination to augment the history that has been elicited.