A Practical Guide to the Utilization of ChatGPT in the Emergency Department: A Systematic Review of Current Applications, Future Directions, and Limitations

Abstract

The rapid development of artificial intelligence (AI) tools across various medical specialties highlights the potential for AI to transform medicine over the next 20 years. Despite this potential, the adoption of AI can feel incremental and disconnected from the daily practice of individual clinicians. For emergency department (ED) physicians practicing in 2025, recognizing and evaluating AI tools available for immediate integration into practice is essential. One such tool is ChatGPT (OpenAI, San Francisco, California, United States), a large language model (LLM) that is free, easily accessible via smartphones or computers, and widely used across industries. However, its usability in the ED setting remains poorly characterized. This review explores the current evidence surrounding ChatGPT 4's applications in various ED physician tasks, documenting its strengths and limitations. While ChatGPT demonstrates significant utility in language generation and administrative tasks, its potential for supporting more complex tasks in medical decision-making is emerging but not yet robust. The available evidence is limited and variable and lacks standardization, reflecting a field still in its early stages of development. Notably, the performance improvements observed between ChatGPT 3.5 and ChatGPT 4 suggest that future iterations, such as the anticipated release of ChatGPT 5, could significantly impact these findings. This review provides a comprehensive snapshot of the current state of evidence regarding ChatGPT's use in the ED, offering both an evaluation of its capabilities and a practical guide for its appropriate use by ED clinicians today.

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