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This study developed a predictive model using deep learning (DL) and natural language processing (NLP) to identify emergency cases in pediatric emergency departments. It analyzed 87,759 pediatric cases from a South Korean tertiary hospital (2012–2021) using electronic medical records. Various NLP models, including four machine learning (ML) models with Term Frequency-Inverse Document Frequency (TF-IDF) and two DL models based on the KM-BERT framework, were trained to differentiate emergency cases using clinician transcripts. Gradient Boosting, among the ML models, performed best with an AUROC of 0.715, AUPRC of 0.778, and F1-score of 0.677. DL models, especially the fine-tuned KM-BERT model, showed superior performance, achieving an AUROC of 0.839, AUPRC of 0.879, and F1-score of 0.773. Shapley-based explanations provided insights into model predictions, underlining the potential of these technologies in medical decision-making. This study demonstrates the potential of advanced DL techniques for NLP in emergency medical settings, offering a more precise and efficient approach to managing healthcare resources and improving patient outcomes. [ABSTRACT FROM AUTHOR]