Medical Diagnoses in ER: A Comprehensive Review of Medical Conditions in Season 15
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Season 15 of ER marks the end of an era, closing the doors on County General with a blend of nostalgia and high-stakes medicine. The final season revisits the show's roots while pushing forward with complex trauma cases, rare toxicological emergencies, and the emotional toll of critical care. From the devastating loss of Dr. Pratt to the intricate management of heart transplant rejection, the season serves as a powerful testament to the resilience of emergency medicine.
Below is a comprehensive, episode-by-episode review of the medical cases, diagnoses, and treatments presented in Season 15.
Content ⁉️
Episode 1
Traumatic Carotid Artery Laceration (Brain Death)
Dr. Greg Pratt. A victim of an ambulance explosion initially stable but with a neck hematoma. Diagnosis: Carotid Artery Laceration from a mandibular fracture fragment. Treatment: Emergency ligation, cardiopulmonary bypass. Outcome: Brain Death confirmed by isoelectric EEG and apnea test (PCO2 74). Organs harvested.
Other Medical Diagnoses and Conditions Discussed
Blast Lungs: Diffuse pulmonary contusions.
Cyanide Poisoning: Inhalation injury from burning car interior.
Epidural Hematoma: Neurosurgical emergency.
Impetigo: Pediatric skin infection.
Moderate Persistent Asthma: Chronic respiratory condition.
Episode 2
Compartment Syndrome (Ricin Scare)
Felix. A patient with a broken leg in a quarantined room. Diagnosis: Compartment Syndrome from a severed tibial artery bleeding into soft tissue. Treatment: Emergency Fasciotomy performed under isolation conditions.
Status Asthmaticus
Jacob. A bystander in the quarantined room. Diagnosis: Status Asthmaticus triggered by stress/irritants. Treatment: Emergency intubation and IV epinephrine (due to lack of albuterol).
Other Medical Diagnoses and Conditions Discussed
Bullous Pemphigoid: Autoimmune skin disorder.
Acalculous Cholecystitis: Gallbladder inflammation without stones.
Obstructive Pancreatitis: Blockage of pancreatic duct.
Thalassemia: Hereditary anemia.
Episode 3
Gunshot Wound with Tension Pneumothorax
Paul Traylor. A GSW victim with respiratory distress. Diagnosis: Tension Pneumothorax created by an occlusive dressing valve effect. Complication: Iatrogenic Splenic Hemorrhage from a chest tube placed through the diaphragm. Treatment: Fibrin glue via chest tube and splenectomy.
Other Medical Diagnoses and Conditions Discussed
Intussusception: Bowel telescoping.
Subclavian Catheter Malposition: Line in the jugular vein.
Grade Five Liver Injury: Severe hepatic trauma.
Episode 4
Pediatric Femur Fracture (Intentional Injury)
Julie O’Fallon. A fall victim with respiratory decline. Diagnosis: Femur Fracture and Intentional Respiratory Sabotage (oxygen turned off) by her sister. Underlying Issue: Sibling rivalry/psychopathy.
Pulmonary Artery Rupture
Mrs. Holmes. An MVA victim with hemothorax. Diagnosis: Right Pulmonary Artery and Vein Rupture. Treatment: Emergency right-sided thoracotomy and hilar clamping.
Other Medical Diagnoses and Conditions Discussed
Orbital Blowout Fracture: Eye trauma.
Post-Operative Billroth Abscess: Gastric surgery complication.
Reflux Esophagitis: Acid reflux.
Acute Polysubstance Intoxication: Drug cocktail.
Episode 5
Subdural Hematoma
Danny Raskin. A school fight victim with nosebleed and headache. Diagnosis: Subdural Hematoma. Treatment: Surgical evacuation.
Brachial Artery Laceration
James Mackey. A GSW victim with pulseless arm. Diagnosis: Brachial Artery Laceration. Treatment: Vascular repair and auto-transfusion.
Other Medical Diagnoses and Conditions Discussed
Recurrent Pericardial Effusion: Fluid around heart.
Morphine Overdose: Pinpoint pupils.
Amphetamine Toxicity: Dilated pupils.
Episode 6
Diffuse Axonal Injury (DAI)
Derrek Taylor. A boxer with facial trauma. Diagnosis: Diffuse Axonal Injury (missed on initial CT) identified by visual field deficit. Complication: Intercostal artery tear during chest tube insertion.
Cauda Equina Syndrome (Resolved)
Patty McPhee. A cyclist with leg pain and foot drop. Diagnosis: Suspected Cauda Equina Syndrome. Outcome: Spontaneous resolution after a "levitating gurney" mishap acted as chiropractic manipulation.
Retrograde Amnesia
Max. A veteran with seizures. Diagnosis: New-Onset Seizure and Retrograde Amnesia of unknown etiology.
Other Medical Diagnoses and Conditions Discussed
Septal Hematoma: Nasal injury requiring drainage.
Malrotation/Volvulus: Intestinal twisting.
Digitoxicity: Digitalis overdose.
Spinal Stenosis: Narrowing of spinal canal.
Episode 7
Acute Leukemia (Pediatric)
Daryl. A child with stroke and hematemesis. Diagnosis: Acute Leukemia causing hyperleukocytosis ("sludging"). Treatment: Emergency leukapheresis attempted. Outcome: Fatal.
Diltiazem Toxicity
Valecia Herrero. A near-drowning victim with refractory V-fib. Diagnosis: Accidental Diltiazem Toxicity (Calcium Channel Blocker). Treatment: Calcium IV pushes restored sinus rhythm.
Traumatic Brain Injury (TBI)
Max Gonzalez. A veteran with behavioral changes. Diagnosis: Diffuse Axonal Injury from prior combat trauma, confirmed by MRI.
Other Medical Diagnoses and Conditions Discussed
Tumor Lysis Syndrome: Oncologic emergency.
Mallory-Weiss Tear: Esophageal laceration.
Middle Cerebral Artery Stroke: Brain infarction.
Episode 8
Retrobulbar Hematoma
Henry Lotery. A fire victim with vision loss. Diagnosis: Retrobulbar Hematoma compressing the optic nerve. Treatment: Emergency Lateral Canthotomy performed by an intern.
Blunt Abdominal Trauma
Beth Lotery. A fall victim with hypoxia. Diagnosis: Subcapsular Hematoma (Liver/Spleen). Treatment: Surgical repair.
Other Medical Diagnoses and Conditions Discussed
Perforated Diverticulum: Colon rupture.
Suspected Melanoma: Skin cancer check.
Flail Chest: Rib instability.
Episode 9
Delayed Aortic Rupture
Alex. An MVA driver with SVT. Diagnosis: Delayed Aortic Rupture presenting as sudden PEA arrest. Treatment: Emergency resuscitative thoracotomy with aortic cross-clamping.
Other Medical Diagnoses and Conditions Discussed
Open Skull Fracture: Brain exposure.
Cardiac Tamponade: Pericardial fluid.
Multi-Substance Overdose: Bicarbonate treatment.
Episode 10
Fetal Cervical Mass (EXIT Procedure)
Gloria Ortiz. A pregnant patient with a fetal tumor. Diagnosis: Fetal cervical mass obstructing the airway. Treatment: EXIT Procedure (Ex Utero Intrapartum Treatment) to secure the airway before cord cutting.
Recurrent Small Bowel Adenocarcinoma
Renee Weber-Stewart. A cancer survivor with syncope. Diagnosis: Recurrent Adenocarcinoma. Treatment: High-risk debulking surgery.
Other Medical Diagnoses and Conditions Discussed
Trichotillomania: Compulsive hair pulling.
Acute Uterine Atony: Postpartum hemorrhage.
Accidental Cannabis Intoxication: Staff brownie incident.
Episode 11
Tension Pneumothorax
Jermaine Bennett. A GSW victim with hypotension. Diagnosis: Tension Pneumothorax identified by tracheal shift. Treatment: Needle decompression and chest tube.
Acute Cholecystitis
Anastasia Johnson. A sickle cell patient with abdominal pain. Diagnosis: Acute Cholecystitis, differentiated from sickle crisis by ultrasound. Treatment: Cholecystectomy.
Other Medical Diagnoses and Conditions Discussed
Vaso-occlusive Crisis: Sickle cell pain.
Ovarian Insufficiency: Infertility workup.
Bell’s Palsy: Facial paralysis.
Episode 12
Internal Abdominal Hemorrhage
Nick Vasquez. A "dream runner" who fell from a window. Diagnosis: Massive internal hemorrhage confirmed by Diagnostic Peritoneal Lavage (DPL). Treatment: Emergency thoracotomy.
VRE Sepsis and Cholecystitis
Ana. A septic patient with Vancomycin-Resistant Enterococcus (VRE). Diagnosis: Cholecystitis. Treatment: Percutaneous drainage (too unstable for surgery).
Other Medical Diagnoses and Conditions Discussed
Iatrogenic Bile Duct Injury: Surgical complication.
Compartment Syndrome: Muscle pressure injury.
Acute Chest Syndrome: Pulmonary sickle cell complication.
Episode 13
Traumatic Splenic Rupture
Barbara Feingold. A fall victim with hypotension. Diagnosis: Splenic Rupture (missed on initial scan) and tension pneumothorax. Treatment: Splenectomy.
Adrenaline-Induced Tachycardia
Babu. A lottery winner with palpitations. Diagnosis: Psychosomatic Tachycardia from excitement/anxiety.
Other Medical Diagnoses and Conditions Discussed
Pediculosis: Lice infestation.
Open Fibula Fracture: Bone exposure.
Anaphylaxis: Allergic reaction to Ancef.
Episode 14
Disseminated Tuberculosis
Donna. A patient misdiagnosed with lung cancer. Diagnosis: Disseminated Tuberculosis (Scrofula). Treatment: Anti-TB antibiotics.
Appendicitis (NOTES Procedure)
Damien. A polio survivor in an iron lung. Diagnosis: Appendicitis. Treatment: NOTES (Natural Orifice Transluminal Endoscopic Surgery) appendectomy via the mouth/stomach to preserve abdominal muscle function.
Multi-Infarct Dementia
Dr. Oliver Kostin. An elderly patient with hypernatremia. Diagnosis: Multi-Infarct Dementia. Outcome: Palliative care.
Other Medical Diagnoses and Conditions Discussed
Post-Expansion Pulmonary Edema: Complication of thoracentesis.
Penetrating Chest Trauma: GSW.
Episode 15
Fulminant Myocarditis
Joanie Moore. An MVA victim with pulmonary edema. Diagnosis: Fulminant Myocarditis (Viral heart infection). Treatment: Supportive care/Transplant list.
Perforated Ulcer
Leo Malcolm. An elderly male with hypotension. Diagnosis: Perforated Ulcer from NSAID use, confirmed by free air. Treatment: Surgery.
Spinal Epidural Abscess
Back Pain Patient. Patient with fever and paralysis. Diagnosis: Spinal Epidural Abscess. Treatment: Emergency decompression.
Other Medical Diagnoses and Conditions Discussed
Foreign Body Ingestion: Swallowed teeth.
Seizure Disorder: Low Dilantin levels.
Airbag Burn: Thermal injury.
Episode 16
Hypersensitivity Pneumonitis
Teddy Lempel. A mycologist with lung nodules. Diagnosis: Mushroom Worker’s Lung (Hypersensitivity Pneumonitis). Cause: Fungal spores.
Cerebral Contusions
Police Witness. A head trauma victim. Diagnosis: Multiple Cerebral Contusions and edema. Treatment: Emergency ventriculostomy.
Heart Transplant Rejection (L-VAD Failure)
Joanie. A transplant candidate. Complication: L-VAD Failure and ABO incompatibility with donor heart.
Other Medical Diagnoses and Conditions Discussed
Penetrating Abdominal Trauma: Tire iron injury.
Basal Skull Fracture: Head trauma.
Episode 17
Spinal Air Embolism (Blast Injury)
Norman Chapman. A blast victim with paralysis. Diagnosis: Spinal Air Embolism from lung injury. Treatment: Hyperbaric oxygen therapy.
Amyloidosis (Schistosomiasis)
Dr. John Carter. Diagnosis: Secondary Amyloidosis from chronic Schistosomiasis causing renal failure. Treatment: Dialysis/Transplant.
Other Medical Diagnoses and Conditions Discussed
Hemopneumothorax: Chest trauma.
Pseudotumor: Intracranial pressure.
Frostbite: Cold injury.
Episode 18
Hyperkalemia (Renal Failure)
Dr. John Carter. A transplant candidate with arrest. Diagnosis: Hyperkalemia (K+ 7.6). Treatment: Calcium, Insulin, Glucose, Dialysis.
Frontal Lobe Stroke
Mary Taggart. A stroke patient with behavioral changes. Diagnosis: Frontal Lobe Injury causing disinhibition.
Other Medical Diagnoses and Conditions Discussed
Rectal Foreign Body: Removal required.
PCP Intoxication: Behavioral emergency.
Nosocomial Infection: Hospital-acquired.
Episode 19
Hyponatremia (Infant)
Abandoned Infant. A baby with seizures. Diagnosis: Severe Hyponatremia from diluted formula. Treatment: Hypertonic saline.
Arterial Thrombosis (Kidney Transplant)
Dr. John Carter. Intraoperative complication. Diagnosis: Renal Artery Thrombosis. Treatment: Vascular revision and reperfusion.
Brain Death
Billy. A bicycle accident victim. Diagnosis: Brain Death confirmed by cerebral blood flow study. Outcome: Organ donation.
Other Medical Diagnoses and Conditions Discussed
Central Pontine Myelinolysis: Rapid sodium correction risk.
Endocarditis: Valvular infection.
Episode 20
Subarachnoid Aneurysm
Darrion Walters. A fall victim with headache. Diagnosis: Subarachnoid Hemorrhage from a ruptured aneurysm. Treatment: Surgical clipping.
Acute Porphyria
Female Patient. A patient with psychosis and abdominal pain. Diagnosis: Acute Porphyria, confirmed by Woods lamp (urine fluorescence).
Other Medical Diagnoses and Conditions Discussed
Calcium Channel Blocker Overdose: Bradycardia.
Small Bowel Perforation: Surgical emergency.
Episode 21
Pulmonary Embolism in Pregnancy
Hedda Langford. A pregnant patient with DVT. Diagnosis: Pulmonary Embolism. Treatment: TPA (Tissue Plasminogen Activator).
Tracheo-Innominate Fistula
Trach Patient. Massive neck hemorrhage. Diagnosis: Tracheo-Innominate Artery Fistula. Treatment: Digital compression and surgery.
Other Medical Diagnoses and Conditions Discussed
Botfly Infestation: Parasitic skin infection.
Tetralogy of Fallot: Congenital heart defect.
Hypoplastic Left Heart Syndrome: Severe congenital defect.
Episode 22
Primary Effusion Lymphoma (AIDS)
Mr. Gandhi. An AIDS patient with hypoxia. Diagnosis: Primary Effusion Lymphoma. Outcome: Palliative care.
Uterine Inversion and Placenta Accreta
Lisa Salamunovich. A trauma patient in labor. Diagnosis: Uterine Inversion and Placenta Accreta. Treatment: Manual reduction and hysterectomy. Outcome: Fatal.
Severe Alcohol Poisoning
Stacey Taylor. A teen with coma. Diagnosis: Alcohol Poisoning (BAL 4.20). Treatment: Intubation and support.
Other Medical Diagnoses and Conditions Discussed
Leukemia Cutis: Skin infiltration.
Penile Fracture: Traumatic rupture.
Meconium Aspiration: Neonatal distress.
🔖 Key Takeaways
🗝️ The End of an Era: Season 15 brings closure to long-running storylines, including Dr. Carter's kidney transplant and Dr. Pratt's tragic death, emphasizing the physical and emotional toll of emergency medicine.
🗝️ Diagnostic Zebras: The season features rare conditions like Fazio-Londe Disease, Acute Porphyria, and Leber's Congenital Amaurosis, showcasing the diagnostic acumen required in the ER.
🗝️ Trauma Innovation: Procedures like the EXIT procedure for a fetal tumor, NOTES appendectomy for a polio survivor, and emergency canthotomy for retrobulbar hematoma highlight cutting-edge interventions.
🗝️ Toxicology Awareness: Cases involving Diltiazem toxicity, Ricin scares, and mushroom hypersensitivity demonstrate the breadth of toxicological emergencies.
🗝️ Global and Social Medicine: The show continues to address global health issues (AIDS/TB in diverse populations) and social determinants of health (diluted formula due to poverty).
Keywords: Medical Diagnoses ER Season 15
Medical Diagnoses ER Season 15
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