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Assessment and management of abdominal pain patients in the prehospital setting are difficult for a variety of reasons. The following objectives apply:

 The initial priority must be to recognize patients with abnormal vital signs and provide hemodynamic support;

 Consider life‐threatening conditions that can present with abdominal complaints (Box 19.1);

 Recognize high‐risk patient populations, including the elderly, children, females of childbearing age, and patients who are immunocompromised (e.g., human immunodeficiency virus [HIV] patients, cancer patients, transplant patients, others receiving immunosuppressive agents); andBox 19.1 Life‐threatening conditions causing abdominal painAbdominal aortic aneurysm (ruptured)Acute myocardial infarctionAortic dissectionBowel obstruction/perforationDiabetic ketoacidosisEctopic pregnancy (ruptured)Envenomation (e.g., black widow spider bite)Mesenteric ischemiaPancreatitisPeritonitisPoisoning/overdose (e.g., iron tablets)Tubo‐ovarian abscess

 Be aware of extra‐abdominal and systemic illnesses that can present with abdominal pain, including acute myocardial infarction, pneumonia, and diabetic ketoacidosis (Box 19.2).