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In the case of the diagnostically undifferentiated patient, EMS clinicians should use appropriate prehospital diagnostic tests to facilitate the working diagnosis. This includes such tests as the fingerstick glucose assessment and a prehospital 12‐lead ECG. The following strategies can also be used to improve the clinical decision making for use of diagnostic tests [7, 9–11].

 Employ any readily available decision‐making algorithms or decision rules. A classic example is the Ottawa Ankle Rules, which help emergency physicians in deciding on ordering ankle x‐rays for injured patients. Although there are very few clinical guidelines in practice for the out‐of‐hospital setting, with the increasing body of evidence, these will increase in the future.

 Use existing prehospital protocols for specific therapeutic decisions whenever possible.

 Use only those tests that will affect the disposition or treatment of the patient by confirming or excluding the disease hypothesis at hand.