Medical Diagnoses in ER: A Comprehensive Review of Medical Conditions in Season 14
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Season 14 of ER marks a return to high-stakes, character-driven medicine, with staff members themselves becoming the patients in some of the series' most critical storylines. From Neela Rasgotra's life-threatening crush injury to the silent progression of rare genetic disorders, the season explores the fragility of the human body and the resilience required to treat it. The medical narratives emphasize the importance of rapid trauma assessment, the dangers of unregulated medications, and the complex ethical decisions faced in emergency care.
Below is a comprehensive, episode-by-episode review of the medical cases, diagnoses, and treatments presented in Season 14.
Content ⁉️
Episode 1
Complex Liver Laceration and Rhabdomyolysis
Neela Rasgotra. A resident physician trampled during a crowd surge. Diagnosis: Stellate "Bear-Claw" Liver Laceration causing massive hemorrhage. Complication: Severe Rhabdomyolysis from crush injury led to hyperkalemia (K+ 8.1) and cardiac arrest (V-tach/PEA). Treatment: Medical management of hyperkalemia (calcium, insulin, glucose) followed by emergency laparotomy using the Pringle Maneuver and argon-beam coagulation.
Other Medical Diagnoses and Conditions Discussed
STEMI: Heart attack with V-fib arrest.
Flail Chest: Multiple rib fractures with paradoxical movement.
Pelvic Crush Injury: Severe blunt trauma.
Hip Dislocation: Vascular compromise requiring reduction.
Ruptured Globe: Eye trauma with vision loss risk.
Psilocybin Intoxication: "Magic mushroom" ingestion.
Brachial Artery Injury: Vascular repair needed.
Episode 2
Fazio-Londe Disease
Joshua. A 13-year-old with aspiration pneumonia and dysphagia. Diagnosis: Fazio-Londe Disease (Progressive Bulbar Palsy of Childhood), confirmed by decreased function of cranial nerves IX and X. Prognosis: Terminal, with no curative treatment.
Other Medical Diagnoses and Conditions Discussed
Acute Coronary Syndrome: Ischemic heart disease.
Stroke: Cerebrovascular accident.
Sepsis: Systemic inflammatory response to infection.
Alcohol Withdrawal: Delirium tremens risk.
Intracranial Hemorrhage: Suspected in agitated head trauma patients.
Post-Op Ileus: Bowel paralysis.
Episode 3
Bulimia Nervosa (Cardiac Arrest)
Finn Andrews. A wrestler with syncope. Diagnosis: Bulimia Nervosa leading to severe electrolyte imbalance and V-tach arrest. Complication: Pancreatitis from a large pseudocyst. Treatment: Endoscopic ultrasound drainage and psychiatric referral.
Von Willebrand Disease
Lauren. A GSW victim with persistent oozing. Diagnosis: Von Willebrand Disease, identified by prolonged bleeding time despite normal platelet count. Treatment: DDAVP (Desmopressin) to increase clotting factor.
Other Medical Diagnoses and Conditions Discussed
Temporal Arteritis: Vascular inflammation.
Haemopneumothorax: Chest trauma.
Vasovagal Syncope: Fainting episode.
Cardiac Tamponade: Pericardial fluid accumulation.
Episode 4
Renal Cell Carcinoma
Mr. Grant. A patient with flank pain initially suspected of kidney stones. Diagnosis: Renal Cell Carcinoma (6cm mass) eroding into vessels. Treatment: Emergency angioplasty balloon occlusion of the renal artery to stop bleeding.
Advanced Hip Osteoarthritis
Willy Archibald. A former athlete with hip pain. Diagnosis: End-Stage Osteoarthritis (bone-on-bone). Treatment: Intra-articular steroid injection and total hip replacement referral.
Other Medical Diagnoses and Conditions Discussed
Hyponatremia: Post-gastric bypass complication.
Clostridium Difficile (C-diff): Infectious diarrhea.
Chemotherapy-Related Hemorrhage: Central line complication.
CHF Exacerbation: Fluid overload.
Von Willebrand Disease: Bleeding disorder history.
Episode 5
Brugada Syndrome
Bevan Guang. A driver with syncope and V-tach arrest. Diagnosis: Brugada Syndrome, identified by specific ST-segment elevation in leads V1-V3. Treatment: Defibrillation, Amiodarone, and ICD implantation.
Hydrops Fetalis (Parvovirus B19)
Fetus of Traci Martinez. Ultrasound showed ascites and effusion. Diagnosis: Hydrops Fetalis secondary to maternal Parvovirus B19 infection. Treatment: Intrauterine blood transfusion via the umbilical vein.
Thyroid Storm
Discussion Case. Diagnosis: Thyrotoxic Crisis. Treatment: Propylthiouracil (PTU).
Other Medical Diagnoses and Conditions Discussed
Coumadin Overdose: GI bleed requiring FFP.
Pneumothorax: Chest tube placement.
Anaerobic Skin Infection: Abscess drainage.
Multiple Myeloma: Bone marrow cancer.
Neonatal Sepsis: Bacterial infection.
Episode 6
Aspiration Pneumonia (Fazio-Londe Disease)
Joshua. The teen with Fazio-Londe disease returned in respiratory failure. Diagnosis: Aspiration Pneumonia due to bulbar weakness. Outcome: The patient declined intubation, opting for palliative care (morphine for air hunger).
Perforated Ulcer
"Crohn's Lady." A patient with abdominal pain and psychiatric symptoms. Diagnosis: Perforated Ulcer confirmed by free air on X-ray (Pneumoperitoneum). Treatment: Emergency surgery.
Benzodiazepine Overdose
Heather Baker. A teen with "headache" found to have ingested Valium. Treatment: Flumazenil reversal and activated charcoal.
Other Medical Diagnoses and Conditions Discussed
PCP Intoxication: Agitation requiring sedation.
Shoulder Dislocation: Reduction procedure.
Acute Porphyria: Metabolic differential diagnosis.
Tension Headache: Musculoskeletal pain.
Episode 7
Anomalous Left Main Coronary Artery (ALCAPA)
Burke Baby. An infant with crying spells during feeding. Diagnosis: Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) causing angina and MI. Treatment: Surgical repair.
Neuroleptic Malignant Syndrome (NMS)
JJ Perkins. A nursing home patient with fever and rigidity. Diagnosis: Neuroleptic Malignant Syndrome from Haloperidol. Treatment: Dantrolene and urine alkalinization.
Epiploic Appendagitis
Wang. A patient with RLQ pain. Diagnosis: Epiploic Appendagitis (inflammation of colonic fat pouches). Treatment: Conservative management with NSAIDs.
Other Medical Diagnoses and Conditions Discussed
Hyperthermia: Heatstroke in elderly.
Gastroesophageal Reflux: Infant diagnosis.
Hypernatremia: Dehydration screening.
Meningitis: Differential for fever/stiff neck.
Episode 8
Traumatic Arterial Injury (Femoral Fracture)
Marcus Faneca. A fall victim with a femoral neck fracture. Complication 1: Subcutaneous Emphysema from a pneumothorax causing hypotension. Complication 2: Arterial Hemorrhage during bone realignment. Treatment: Vascular repair and orthopedic stabilization.
Other Medical Diagnoses and Conditions Discussed
Arteriovenous Malformation (AVM): Seizure cause.
Avascular Necrosis: Hip fracture complication.
Open Tib-Fib Fracture: Severe leg trauma.
Episode 9
Ischemic Limb (Traumatic Amputation)
Mr. Murphy. An industrial accident victim with a mangled arm. Diagnosis: Non-Viable Ischemic Limb due to extensive neurovascular damage. Treatment: Surgical amputation to prevent systemic toxicity.
Fatal Intracranial Hemorrhage
Manny Salazar. A beating victim with a blown pupil. Diagnosis: Intracranial Hemorrhage and brain death. Outcome: Fatal after prolonged resuscitation.
Other Medical Diagnoses and Conditions Discussed
Multiple Myeloma: Terminal illness of Luka's father.
Septic Hip: Pediatric emergency.
Cholecystitis: Laparoscopic surgery.
DIC: Coagulopathy in trauma.
Episode 10
End-Stage Emphysema
Melissa Tanner. An MVA victim in respiratory distress. Diagnosis: End-Stage Emphysema (COPD). Outcome: Extubation per DNR order to allow natural death.
Epidural Hematoma (Burr Hole)
Del. A driver with a lucid interval followed by herniation. Diagnosis: Epidural Hematoma. Treatment: Emergency Burr Hole performed in the ER.
Alcohol Use Disorder (Relapse)
Abby Lockhart. Diagnosis: Alcohol Relapse triggered by stress. Treatment: Admission to a rehabilitation facility.
Other Medical Diagnoses and Conditions Discussed
Fat Embolism Syndrome: Fracture complication.
Carpal Tunnel Syndrome: Repetitive stress injury.
Acute Airway Obstruction: Requiring surgical airway.
Episode 11
AIDS-Defining Illness (CNS Lesion)
Carlos Moore. An HIV+ child with seizures. Diagnosis: CNS Toxoplasmosis vs. Lymphoma (Ring-enhancing lesion). Treatment: Pentobarbital coma and stereotactic biopsy.
Other Medical Diagnoses and Conditions Discussed
Distal Tib-Fib Fracture: Ankle trauma.
Nephrotic Syndrome: Kidney disorder.
Rectal Abscess: Surgical drainage.
Episode 12
Leber’s Congenital Amaurosis (LCA)
Kayla Weeks. A child with clumsiness and nystagmus. Diagnosis: Leber’s Congenital Amaurosis, a genetic retinal disorder. Diagnostic Test: Electroretinogram (ERG).
Spinal Cord Contusion
Jake Gleason. A firefighter with a T11 fracture. Diagnosis: Spinal Cord Contusion. Treatment: High-dose steroids and decompression surgery.
Subscapular Liver Hematoma
Dexter Jackson. A blast victim. Diagnosis: Subscapular Liver Hematoma progressing to rupture. Treatment: Emergency laparotomy.
Other Medical Diagnoses and Conditions Discussed
Hypercalcemia: Neuropsychiatric symptoms.
Perilunate Dislocation: Wrist injury.
Laceration: Staple closure.
Episode 13
Metastatic Prostate Cancer
Robert Truman. A rescuer with ischemic EKG changes. Diagnosis: Metastatic Prostate Cancer to lungs/bone. Prognosis: Terminal.
Severe Accidental Hypothermia (ECMO)
Gabriel. A drowning victim with core temp 71°F. Treatment: Extracorporeal Membrane Oxygenation (ECMO) for rewarming. Outcome: Full recovery ("Miracle").
Other Medical Diagnoses and Conditions Discussed
Atelectasis: Lung collapse.
Ventricular Tachycardia: Cold-induced arrhythmia.
Hypocalcemia: Electrolyte imbalance.
Episode 14
Acute Heart Transplant Rejection
Mia. A transplant recipient with hypoxia. Diagnosis: Acute Rejection due to non-compliance with Cyclosporine. Treatment: Anti-rejection drugs and inotropic support.
Anticholinergic Mydriasis
Kelly Robinson. A patient with a fixed, dilated pupil. Diagnosis: Pharmacologic Mydriasis from contact with Jimson Weed (Datura), not brain injury.
Acetylcholine Depletion
Archie Morris. Tased for research. Diagnosis: Acetylcholine Depletion causing temporary paralysis.
Other Medical Diagnoses and Conditions Discussed
Displaced Femoral Neck Fracture: Hip injury.
Alcohol Use Disorder: Chronic disease model.
Episode 15
Traumatic Aortic Dissection
Sheryl Hawkins. Rollover MVA victim. Diagnosis: Aortic Dissection. Treatment: Surgical repair with bifemoral graft.
Superior Mesenteric Artery Embolism
Hank Riley. A-fib patient with abdominal pain. Diagnosis: SMA Embolism causing ischemic bowel. Treatment: Embolectomy.
Hyperparathyroidism (Pathologic Fractures)
Martin Sinula. Patient with multiple fractures. Diagnosis: Hyperparathyroidism causing brittle bones (Osteitis fibrosa cystica). Treatment: Parathyroidectomy.
Other Medical Diagnoses and Conditions Discussed
Wilms Tumor: Pediatric kidney cancer.
Adrenal Tumor: Abdominal mass.
Meniscus Tear: Knee injury.
Episode 16
Large-Cell Lymphoma
Kwan Lee. Trauma patient with a neck mass. Diagnosis: High-Grade Large-Cell Lymphoma. Treatment: Oncology referral.
Placental Abruption (Malpresentation)
Missy Voltaire. Pregnant trauma victim. Diagnosis: Placental Abruption with arm presentation. Treatment: Emergency delivery using McRoberts maneuver.
Aortic Graft Infection
Sheryl Hawkins. Post-op fever. Diagnosis: Infected Aortic Graft. Treatment: Linezolid and surgical revision.
Other Medical Diagnoses and Conditions Discussed
Atelectasis: Post-op fever cause.
Radioulnar Fracture: Arm injury.
Diabetic Ulcer: Foot wound.
Episode 17
Retrohepatic Vena Cava Avulsion
Rebecca Smith. MVA victim with hypotension. Diagnosis: Retrohepatic Vena Cava Injury and liver laceration. Treatment: Emergency thoracotomy and aortic cross-clamping. Outcome: Fatal.
Tibia-Fibula Fracture
Unicycle Boy. Leg trauma. Diagnosis: Tib-Fib Fracture with vascular compromise. Treatment: Reduction under fluoroscopy.
Other Medical Diagnoses and Conditions Discussed
Argyria: Silver poisoning (blue skin).
Carpal Tunnel Syndrome: Nerve compression.
Pancreatic Cancer: Terminal illness.
Episode 18
Fulminant Hepatic Failure (Toxin)
Lois Landry. Patient with jaundice and coagulopathy. Diagnosis: Fulminant Liver Failure from Tetrachloroethane Toxicity (in unregulated estrogen). Outcome: Fatal.
Other Medical Diagnoses and Conditions Discussed
Acinetobacter Sepsis: Resistant infection.
Hepatorenal Syndrome: Liver-kidney failure.
Retinal Detachment: Eye emergency.
Episode 19
Massive Pulmonary Embolism
Mrs. Barcenilla. Lupus patient with shock. Diagnosis: Massive Pulmonary Embolism. Outcome: Fatal PEA arrest.
Acute Myocardial Infarction
Arnie Markowitz. Witness protection patient. Diagnosis: STEMI. Treatment: Cath lab intervention.
Other Medical Diagnoses and Conditions Discussed
Empyema: Pleural infection.
Pan-Resistant Sepsis: Acinetobacter.
Ventricular Tachycardia: Life-threatening arrhythmia.
🔖 Key Takeaways
🗝️ Rare Diagnoses: The season showcased medical "zebras" such as Fazio-Londe Disease, Leber’s Congenital Amaurosis, and Brugada Syndrome, emphasizing the need for broad differential diagnoses.
🗝️ Trauma Innovation: Procedures like emergency burr holes, field amputations (in previous seasons, but thematically linked), and aortic cross-clamping in the ER highlighted the aggressive nature of trauma care.
🗝️ Toxicology Awareness: Cases involving toxins like Tetrachloroethane, Datura (Jimson Weed), and Psilocybin demonstrated the variety of poisoning presentations.
🗝️ Chronic Disease Management: The progression of conditions like COPD (End-stage emphysema), Liver failure (Varices), and Lupus (PE risk) underscored the long-term management challenges in emergency medicine.
🗝️ Diagnostic Pitfalls: The show highlighted errors such as missed PFO leading to stroke and the importance of checking for medical alerts or history (e.g., Anaphylaxis to penicillin) before treatment.
Keywords: Medical Diagnoses ER Season 14
Medical Diagnoses ER Season 14
