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Patients with abdominal complaints who activate the EMS system can be among the most challenging. Their histories may be nonspecific and their exams and vital signs may be unreliable indicators of the etiology or severity of their illnesses. Vital signs are frequently abnormal in critically ill patients. However, normal vital signs do not preclude the presence of a life‐threatening condition. Certain populations with abdominal pain commonly encountered by EMS personnel may deserve special attention, including the elderly, females of childbearing age, children, postbariatric surgery patients, and immunocompromised patients. Additionally, many significant extra‐abdominal conditions can present with mostly abdominal complaints.

Abdominal pain is the most frequent chief complaint in the emergency department, accounting for almost 9% of the total visits [1]. It is also one of the most common reasons to call EMS. At least 1 in 20 EMS calls is for abdominal complaints [2]. It is especially concerning in those over 60 years old, as one study found that 58% were admitted to the hospital and 18% needed surgical intervention [3]. Thus, EMS clinicians encounter patients with abdominal pain on a regular basis, but options for patient assessment and management are limited.