Emergency medicine demands split-second decisions, meticulous documentation, and constant communication across a chaotic environment — all at once. ChatGPT can serve as a powerful cognitive partner for ER physicians, helping you draft documentation faster, rehearse difficult patient conversations, stay current on evidence-based guidelines, and reduce the administrative burden that chips away at your time at the bedside. Whether you're a resident navigating your first overnight shift or an attending managing a full waiting room, these 35 prompts are designed to integrate naturally into your workflow.
Clinical Decision-Making and Differential Diagnosis
Prompt 1: Building a Systematic Differential
I'm evaluating a 58-year-old male presenting with acute onset chest pain radiating to the jaw, diaphoresis, and mild shortness of breath. His HR is 102, BP 148/92, O2 sat 97% on room air. He has a history of hypertension and type 2 diabetes. Generate a prioritized differential diagnosis list organized by must-not-miss diagnoses first, followed by common and less likely causes. For each diagnosis, list the key supporting features from this presentation and the initial workup I should order.
This prompt forces a structured, stepwise approach to a high-stakes presentation and helps prevent anchoring bias by surfacing diagnoses you might otherwise deprioritize under time pressure.
Prompt 2: Pediatric Dosing and Weight-Based Calculations
I have a 4-year-old patient weighing approximately 18 kg presenting with a first-time seizure that has now broken. I need to know the correct weight-based doses for lorazepam (IV/IM/intranasal), levetiracetam (IV load), and fosphenytoin (IV load) in case of recurrence. Also provide the maximum doses and any key contraindications or monitoring parameters I should be aware of for each agent.
Pediatric dosing errors are a leading cause of adverse events in the ED, and having a rapid, weight-based reference reduces cognitive load during stressful resuscitations.
Prompt 3: Interpreting an Abnormal ECG
Walk me through interpreting the following ECG findings in a systematic way: sinus rhythm at 88 bpm, PR interval 0.22 seconds, QRS 0.14 seconds with a left bundle branch block morphology, QTc 480 ms, and 1 mm ST elevation in leads V1-V2. The patient is a 67-year-old woman with no prior cardiac history presenting with palpitations and near-syncope. Highlight the most clinically significant findings, their implications, and the next steps I should take.
Systematic ECG interpretation under pressure is difficult; this prompt ensures you don't overlook subtle but critical findings in a complex tracing.
Prompt 4: Evaluating a Low-Risk Chest Pain Patient for Discharge
I have a 42-year-old woman with atypical chest pain, a HEART score of 3, and two serial troponins six hours apart that are both below the 99th percentile. She has no EKG changes and her pain has resolved. Help me think through whether it is safe to discharge her, what discharge instructions she should receive, what follow-up I should arrange, and how I should document this shared decision-making conversation in a way that is defensible from a medicolegal standpoint.
Low-risk chest pain dispositions are common but carry real liability; this prompt helps you think through the full discharge package systematically.
Prompt 5: Identifying Drug-Drug Interactions in a Complex Patient
My patient is a 72-year-old man taking warfarin, amiodarone, metoprolol, lisinopril, and atorvastatin. I need to add an antibiotic for a soft tissue infection. Compare the interactions of trimethoprim-sulfamethoxazole, ciprofloxacin, cephalexin, and doxycycline with his current medication list. Rank them from highest to lowest interaction risk and recommend the safest choice given his regimen.
Polypharmacy in elderly ED patients is a major source of preventable harm, and this prompt surfaces critical interactions before you write the prescription.
Patient Communication and Shared Decision-Making
Prompt 6: Explaining a Serious Diagnosis to a Patient
Help me explain a new diagnosis of pulmonary embolism to a patient in plain, non-medical language. The patient is a 55-year-old woman with no medical background. Cover what a pulmonary embolism is, why it's dangerous, why she needs to be admitted, what treatment she will receive, and what questions she should expect to have answered before leaving the hospital. Keep the explanation calm, clear, and free of jargon.
Clear communication reduces patient anxiety, improves treatment adherence, and decreases the likelihood of patients leaving against medical advice after a scary diagnosis.
Prompt 7: Conducting a Goals-of-Care Conversation
I need to have a goals-of-care conversation with the family of an 84-year-old man with advanced dementia who has been brought in unresponsive with septic shock. He has no advance directive. His daughter wants everything done, but his son believes aggressive care is not what he would have wanted. Give me a script for opening this conversation that acknowledges both perspectives, introduces the concept of comfort-focused care without being dismissive, and helps the family move toward a shared decision. Include specific phrases I can use.
Goals-of-care conversations in the ED are emotionally charged and time-pressured; a well-structured script helps you stay compassionate and effective even under duress.
Prompt 8: Communicating a Negative Workup to an Anxious Patient
My patient is a 38-year-old man who came in convinced he was having a heart attack. His workup — ECG, troponins, chest X-ray, and basic labs — is completely normal. He is still very anxious and does not believe he is okay. Write a script I can use to validate his concern, explain what we ruled out and why the negative results are reassuring, address the possibility of panic disorder or musculoskeletal chest pain, and motivate him to follow up with his primary care physician without dismissing his experience.
Patients who feel dismissed after a negative workup are less likely to follow up and more likely to return to the ED; this prompt helps you close the loop empathetically.
Prompt 9: Obtaining Informed Consent for a Procedure
I need to perform a lumbar puncture on a 29-year-old presenting with thunderclap headache after a normal CT head. Write a patient-friendly explanation of the procedure that covers: why I'm recommending it, what I'm looking for, how the procedure is performed step by step, the key risks and their approximate frequencies, alternatives I considered and why I'm not recommending them, and what will happen next based on different possible results.
Thorough informed consent for lumbar puncture reduces patient anxiety and procedural refusal, and documents your communication in a legally defensible way.
Prompt 10: Breaking Bad News Using the SPIKES Protocol
Use the SPIKES protocol to help me structure a conversation in which I inform a 45-year-old woman that her husband, who was brought in after a cardiac arrest, did not survive despite our full resuscitation efforts. She is in the waiting room alone. Write out what I should say at each step of the SPIKES framework, including specific language for the 'Perception,' 'Invitation,' 'Knowledge,' and 'Empathy' components. Account for the likelihood that she will be in shock and may not process information immediately.
Delivering death notifications is one of the most difficult tasks in emergency medicine, and the SPIKES framework provides a humane, structured approach that honors the gravity of the moment.
Clinical Documentation and Medical Records
Prompt 11: Drafting an ED Discharge Summary
Write a structured ED discharge summary for the following encounter: a 61-year-old male with a history of COPD who presented with two days of worsening dyspnea, cough productive of green sputum, and a low-grade fever. His exam showed diffuse expiratory wheezes and decreased air entry at the left base. Chest X-ray showed a left lower lobe infiltrate. He was treated with albuterol/ipratropium nebs, IV methylprednisolone 125 mg, azithromycin 500 mg PO, and supplemental oxygen. He improved to his baseline and was discharged home with prescriptions and follow-up instructions. Format this as a professional ED note with chief complaint, HPI, exam, results, assessment, plan, and discharge instructions.
High-quality discharge summaries improve care continuity, reduce readmissions, and protect you medicolegally by clearly documenting your clinical reasoning.
Prompt 12: Writing a Medical Decision-Making Section
Help me write a high-complexity medical decision-making (MDM) section for a 78-year-old woman who presented with altered mental status. I considered and worked up for UTI, acute stroke, hyponatremia, and medication toxicity. Her sodium came back at 126, and I believe the hyponatremia is the likely cause. I consulted nephrology and admitted her for IV fluid management and monitoring. Write the MDM section in a way that clearly demonstrates the number and complexity of diagnoses, the amount of data reviewed and ordered, and the high risk of complications — meeting the threshold for a Level 5 ED visit.
A well-documented MDM section ensures appropriate reimbursement and demonstrates the cognitive complexity of your care, which is often invisible in simple narrative notes.
Prompt 13: Creating a Procedure Note
Write a complete procedure note for a right femoral central venous line placed under ultrasound guidance in a 68-year-old male in septic shock. Include: indication, consent obtained, patient positioning, sterile technique used, ultrasound guidance confirmation, needle insertion, wire passage, dilator use, line placement, confirmation of placement, post-procedure assessment, and any complications. Use standard medical documentation language appropriate for an ED procedure note.
Detailed procedure notes are a medicolegal necessity and ensure that covering teams have complete information about line access, position, and any intraoperative findings.
Prompt 14: Documenting a Trauma Activation
Draft a trauma activation note for a 34-year-old unrestrained driver in a high-speed MVC who arrived via EMS with GCS 13, BP 88/60, HR 124, and multiple rib fractures on CXR. Trauma surgery was activated. Include primary and secondary survey findings, resuscitation measures taken, consultations placed, imaging ordered, and the patient's disposition to the trauma bay for operative evaluation. Format the note to meet ED documentation standards for a high-level trauma encounter.
Comprehensive trauma documentation captures the rapid, multidisciplinary nature of these encounters and is essential for quality review, billing, and potential legal proceedings.
Prompt 15: Generating a Transition-of-Care Handoff
Write an IPASS handoff note for the following patient being transferred to the overnight team: a 52-year-old woman with a history of lupus presenting with pleuritic chest pain and a positive D-dimer. CT pulmonary angiography is still pending. She is hemodynamically stable on 2L O2. I started her on heparin empirically. The key 'if-then' item: if the CTPA is negative for PE, discuss discontinuing heparin and reconsidering her diagnosis — possibly lupus pleuritis — before pursuing outpatient rheumatology follow-up. Format this using the full IPASS framework.
A structured handoff using IPASS significantly reduces errors of omission at transitions of care, which are a leading cause of adverse events in emergency medicine.
Team Coordination and Departmental Leadership
Prompt 16: Briefing the Team Before a High-Acuity Resuscitation
Write a 60-second pre-arrival briefing script for my team before a pediatric trauma arrives: a 7-year-old boy struck by a car at moderate speed, GCS 14 at scene, suspected femur fracture, ETA 4 minutes. I need to assign roles for airway, IV access, bedside ultrasound (FAST), medication preparation, documentation, and family communication. Include a brief statement of our primary goals for the first 10 minutes and what conditions would trigger escalation to RSI.
A structured pre-arrival briefing reduces chaos, clarifies roles, and ensures that every team member knows the plan before the doors open — directly improving patient outcomes.
Prompt 17: Conducting a Post-Resuscitation Debrief
Help me facilitate a 10-minute post-resuscitation debrief after an unsuccessful pediatric code. The team is visibly distressed. I want to acknowledge the emotional weight of the situation, review one or two clinical learning points without assigning blame, reinforce what the team did well, and check in on individual team members who may need additional support. Write a structured script that balances emotional safety with educational value.
Post-resuscitation debriefs improve team resilience, reduce secondary traumatic stress, and extract learning from difficult cases — but only if they are conducted with psychological safety.
Prompt 18: Giving Constructive Feedback to a Resident
I need to give feedback to a second-year EM resident who consistently rushes through patient histories and misses key medication reconciliation details, which has led to two near-miss medication errors this month. Help me structure a feedback conversation using the R2C2 model that: acknowledges his strengths, presents the specific observations without being accusatory, explores his perspective on the cause, and collaboratively sets a measurable improvement goal for the next four weeks.
Feedback delivered using a structured model like R2C2 is more likely to be received, internalized, and acted upon than informal criticism delivered in the middle of a busy shift.
Prompt 19: Managing a Conflict Between Nursing Staff and a Consultant
I am the attending physician managing a conflict between my charge nurse and the orthopedic surgery consultant on call. The consultant is refusing to come in for a patient with a displaced hip fracture, insisting the patient can wait until morning. My nurse believes the patient is deteriorating. Write a script I can use to escalate the situation professionally and assertively, document my attempt to reach the consultant, and protect the patient's interests while preserving working relationships.
Physician-consultant conflicts are a known patient safety risk in emergency medicine; a clear, documented escalation strategy protects the patient and shields you legally.
Prompt 20: Writing a Shift Huddle Agenda for a High-Census Day
Write a 5-minute shift huddle agenda for my 7 AM day shift team during a period of high ED census and a 4-hour wait time. Include: safety priorities, current boarding patients who need reassessment, anticipated high-acuity arrivals from the ICU transfer list, a brief reminder about our sepsis bundle compliance rate from last week, and one wellness check-in question for the team. Keep it focused, energizing, and under 300 words.
A purposeful shift huddle aligns the team, surfaces safety concerns early, and sets a tone of calm professionalism even when the department is under strain.
Continuing Education and Guideline Review
Prompt 21: Summarizing a Recent Clinical Guideline
Summarize the key clinical takeaways from the most recent ACEP guidelines on the management of acute asthma exacerbations in adults in the emergency department. Focus on: criteria for severity stratification, first-line bronchodilator therapy and dosing, the role of systemic corticosteroids, when to consider heliox or magnesium sulfate, intubation triggers and ventilator settings for severe asthma, and discharge criteria. Present this as a structured quick-reference card I could use for teaching medical students.
Regularly refreshing your knowledge of evidence-based guidelines through structured summaries keeps your practice current and improves the quality of education you deliver to trainees.
Prompt 22: Preparing a Journal Club Presentation
Help me prepare a 15-minute journal club presentation on this study: [paste abstract]. Structure the presentation to cover: background and clinical question, study design and methods, key results with statistical significance, limitations and potential biases, and the bottom line for our ED practice. Include two or three discussion questions that will generate a productive conversation among residents about how to apply — or not apply — this evidence to our patient population.
Journal club presentations that follow a rigorous critical appraisal framework build evidence-based medicine skills in residents and help the department collectively decide how to update practice.
Prompt 23: Creating a Teaching Case Presentation
Turn the following clinical case into a structured teaching presentation for EM residents: a 44-year-old woman with no medical history presenting with sudden-onset severe headache, neck stiffness, and photophobia. CT head was negative. LP showed xanthochromia and elevated RBCs. She was diagnosed with a subarachnoid hemorrhage. Structure the case as: case introduction, interactive differential building, key diagnostic decision points, management pearls, and disposition considerations. Include two or three "what if" scenarios to test residents' reasoning.
Case-based teaching that uses real ED presentations builds pattern recognition and clinical reasoning in residents far more effectively than didactic lectures alone.
Prompt 24: Explaining a Complex Pathophysiology Concept
Explain the pathophysiology of high-anion-gap metabolic acidosis using the MUDPILES mnemonic in a way that is engaging and memorable for third-year medical students on their emergency medicine rotation. Connect each cause to a real-world ED presentation they might encounter, and explain why understanding the anion gap calculation changes your management approach for each etiology.
Teaching trainees to connect pathophysiology to real clinical scenarios builds durable knowledge and transforms a routine lab value into a powerful diagnostic tool.
Prompt 25: Studying for a Board Exam or Recertification
I am preparing for my ABEM Continuous Certification examination and want to focus on the topic of toxicology. Generate 10 high-yield board-style multiple choice questions covering common ED toxidromes, antidotes, and management principles. After each question, provide the correct answer with a detailed explanation of why each distractor is wrong and one key clinical pearl I should remember for practice and the exam.
Active recall using board-style questions is the most evidence-based study method for medical licensing exams and reinforces key concepts that have direct patient care implications.
Administrative and Quality Improvement Tasks
Prompt 26: Drafting a Quality Improvement Project Proposal
Help me write a one-page quality improvement project proposal for reducing door-to-EKG time in our ED for patients presenting with chest pain. Our current average is 18 minutes and our target is under 10 minutes per AHA guidelines. Include: the problem statement, a brief literature review, our proposed intervention (a triage-initiated EKG protocol), outcome measures, a PDSA cycle structure, and how we will track success over 90 days.
A well-structured QI proposal that ties a clinical problem to measurable outcomes is more likely to gain institutional support and lead to lasting improvements in patient care.
Prompt 27: Responding to a Patient Complaint
A patient has submitted a formal complaint stating that she waited four hours to be seen, felt ignored by nursing staff, and was discharged without understanding her diagnosis. Help me write a professional, empathetic response letter that: acknowledges her experience without admitting liability, explains (without excusing) the realities of ED triage, describes the steps we are taking to improve communication and wait times, and invites her to contact our patient relations team for further discussion.
A thoughtful, timely response to patient complaints reduces the likelihood of escalation to formal complaints or legal action and demonstrates a commitment to continuous improvement.
Prompt 28: Preparing for a Department Peer Review
I have been asked to present a case at our monthly ED peer review committee. The case involves a 60-year-old man who was discharged from the ED after a work-up for syncope and subsequently had a fatal cardiac arrhythmia 12 hours later. Help me prepare a fair, objective presentation that covers: the clinical facts as documented, the decision-making at the time, applicable evidence-based guidelines for syncope risk stratification, identification of any learning opportunities, and a proposed process change to prevent similar outcomes.
A well-prepared peer review presentation that focuses on systems rather than individual blame creates a psychologically safe environment for learning and drives meaningful practice change.
Prompt 29: Writing a Policy Recommendation for the ED Medical Director
Help me write a one-page memo to our ED medical director recommending that we adopt a physician-in-triage model during our peak hours of 10 AM to 4 PM. Include: the clinical and operational rationale, evidence from peer-reviewed literature supporting this model, a cost-benefit summary, anticipated implementation challenges and proposed solutions, and measurable metrics we would use to evaluate success at 6 months.
A data-driven, solution-oriented recommendation memo is far more persuasive to hospital leadership than an informal conversation and demonstrates physician ownership of operational problems.
Prompt 30: Analyzing ED Metrics and Patient Flow Data
I have the following ED performance data from last quarter: mean door-to-physician time 24 minutes, left without being seen rate 4.2%, average length of stay for admitted patients 7.8 hours, 72-hour return rate 3.1%, and patient satisfaction scores in the 42nd percentile. Help me interpret these metrics, identify which ones represent the most significant clinical and operational risks, and generate a prioritized list of three to four targeted interventions I could propose to administration with the greatest likelihood of improving multiple metrics simultaneously.
Understanding and acting on ED performance data is a core competency for EM physicians in leadership roles and is essential for making the case for resources and staffing changes.
Research and Evidence-Based Medicine
Prompt 31: Critically Appraising a Diagnostic Study
Help me critically appraise a study evaluating the diagnostic accuracy of point-of-care ultrasound for detecting pneumothorax in trauma patients. The study reports a sensitivity of 88% and specificity of 99% compared to CT chest as the gold standard. Walk me through: how to assess the validity of the reference standard, whether spectrum bias may affect these results in my ED population, how to calculate and interpret the positive and negative likelihood ratios, and whether I should incorporate this test into my trauma protocol given these numbers.
Ability to critically appraise diagnostic accuracy studies is essential for deciding which point-of-care tests to adopt and for teaching residents to use evidence rather than habit.
Prompt 32: Designing a Research Question Using the PICO Framework
I want to investigate whether early administration of IV ketamine for pain control in patients with long bone fractures reduces total opioid consumption in the ED compared to opioids alone. Help me frame this as a PICO research question, identify the most appropriate study design given our ED resources, list the key outcomes I should measure, identify potential confounders I need to control for, and suggest how I might approach IRB approval for a retrospective chart review as a starting point.
A well-defined PICO question is the foundation of any credible clinical research project and helps you focus your data collection and avoid scope creep.
Prompt 33: Searching and Summarizing Literature on an Unfamiliar Topic
I have a patient presenting with signs consistent with necrotizing fasciitis but the imaging is equivocal and surgery is hesitant to take her to the OR. Summarize the current evidence on the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score — its derivation, validation studies, sensitivity and specificity, key limitations, and whether contemporary literature supports or refutes its clinical utility. Help me formulate an evidence-based argument for surgical exploration despite the equivocal imaging.
Being able to rapidly synthesize the evidence on a contentious clinical question in real time can be the difference between a timely life-saving intervention and a fatal delay.
Prompt 34: Writing an Abstract for a Conference Submission
Help me write a structured abstract for submission to ACEP Scientific Assembly. The study is a retrospective cohort analysis of 450 patients presenting to our ED with undifferentiated abdominal pain who received point-of-care ultrasound compared to those who received standard imaging. Key findings: POCUS group had a 38-minute reduction in time to diagnosis, no significant difference in missed diagnoses at 30-day follow-up, and lower total imaging costs per patient. Format the abstract with the sections: Background, Objectives, Methods, Results, and Conclusions. Keep it under 350 words.
A well-crafted abstract that clearly articulates the clinical significance of your findings maximizes the likelihood of acceptance to high-profile conferences and increases the impact of your work.
Prompt 35: Translating Research Findings Into a Clinical Protocol
I want to implement a nurse-initiated sepsis protocol in our ED based on the Surviving Sepsis Campaign guidelines. Help me translate the key evidence-based elements into a practical, one-page clinical protocol that nursing staff can initiate before physician evaluation. Include: screening criteria using qSOFA and SIRS, the first-hour bundle elements (blood cultures, lactate, IV access, fluid initiation), documentation requirements, escalation triggers for physician notification, and the quality metrics we should track to evaluate adherence and patient outcomes.
Translating complex guidelines into simple, actionable protocols is one of the highest-leverage activities a physician leader can undertake — and it directly reduces the time from evidence to bedside practice.
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