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It is difficult for EMS personnel to identify patients who do not require transport and to make a decision regarding the need for medical evaluation in an ED. It is possible that a patient may not require EMS transport but may still require medical evaluation. Researchers have previously evaluated the accuracy of such decisions. When EMS clinicians were compared with physicians regarding need for patients to be transported, EMS clinician judgment was 22.1% sensitive and 80.5% specific [26]. The presence of abdominal pain was found to be highly associated with the need for transport as judged by the physicians. On the other hand, one study found 84% over‐triage with regard to provision of ALS care to patients with abdominal pain [27]. Significant under‐triage may also occur; 11% in one investigation [28]. Multiple evaluations have confirmed significant under‐triage by EMS personnel for a variety of medical conditions [29–31]. These studies reaffirm the need to exercise caution in approaching transport decisions in patients with abdominal complaints.