THE PITT // CASEBOOK

Critical Care Cases From THE PITT

14 cases 9 episodes · S01E01 – S02E14

All emergency department cases involving Critical Care from The Pitt, documented with medically accurate clinical timelines, diagnostic workups, and expert clinical pearls.

Patient arrived via EMS after a head-on MVC into a telephone pole.
S02E14 Moderate
53 · Male

Lyman Paine

Involved in a single-vehicle head-on collision into a telephone pole.

53-year-old male presents post single motor vehicle collision. He drove head-on into a telephone pole. Airbags deployed. He was unconscious at the scene but woke up during transport. There is no scent of alcohol; EMS suspects syncope, seizure, or falling asleep at the wheel. Initially stable upon ED arrival, he shortly develops progressive bilateral upper extremity paresthesia and impending respiratory failure.

TraumaNeurosurgery +2 more
Patient presenting in acute respiratory distress, utilizing a handheld nebulizer mouthpiece while demonstrating visible accessory muscle use and wheezing.
S02E13 Complex
16 · Male

Grady Barnhill

Severe wheezing, shortness of breath, unresponsive to home albuterol.

Patient has a lifelong history of asthma. Lost Medicaid coverage two months ago due to a missed redetermination letter, resulting in inability to afford maintenance inhalers (Symbicort, montelukast). Has only been using albuterol. Presented to the ED in severe respiratory distress after using home nebulizer every hour without relief.

PulmonologyCritical Care +2 more
Patient unresponsive on backboard after 20-foot fall.
S02E13 Complex
Adulte · Male

Orlando Diaz

Unresponsive after 20-foot fall.

Orlando Diaz is a patient who was previously admitted for Diabetic Ketoacidosis (DKA). He eloped Against Medical Advice (AMA) because he could not afford to miss a paycheck at his second job. Shortly after leaving, he fell approximately 20 feet at his worksite. He was found unresponsive by coworkers after failing to answer his radio and brought back to the ED by EMS.

TraumaNeurosurgery +2 more
Patient arriving via private vehicle in severe respiratory distress.
S02E12 Complex
55 · Male

Oliver Haas

Severe respiratory distress and hypoxia

Oliver Haas is a patient with End-Stage Renal Disease (ESRD) on a Monday/Wednesday/Friday hemodialysis schedule. He missed his Friday session due to attending a wedding. His son attempted to take him to the local clinic on Saturday morning, but it was closed for the 4th of July holiday. With their local rural hospital (Pine Ridge) permanently closed, his 20-year-old son Mason drove him 1.5 hours to The Pitt. Patient arrived in extremis, exhibiting severe respiratory distress and altered mental status upon arrival.

NephrologyDialysis +4 more
Provider performing costovertebral angle (CVA) percussion on Mr. Green.
S02E09 Complex
Middle-aged · Male

Mr. Green

Left flank pain

Patient presents to the ED with left-sided flank pain that began at 10:00 p.m. the previous night. He has a history of kidney stones and states this episode feels exactly the same as prior occurrences. He notes his urine is 'a bit darker than normal' but denies fever or gross hematuria. He suspects he is dehydrated.

UrologyRenal Colic +7 more
Dr. Mohan sitting at the bedside of Orlando Diaz.
S02E02 Complex
Adult · Male

Orlando Diaz

Altered mental status and head trauma after a fall.

Patient was brought to the ED by a friend via private vehicle. The friend reports the patient tripped over rebar and hit his head. The patient initially refused to let the friend call 911 and was conversant, but his mental status deteriorated significantly en route to the hospital. Triage assessment noted a fruity, ketotic odor on the patient's breath.

EndocrinologyTrauma +4 more
Patient Wendell Stone in the ED on a nasal cannula. The background monitor displays tachycardia (HR 115) and significant hypoxia (SpO2 85%).
S01E04 Moderate
52 · Male

Wendell Stone

Isolated left chest trauma from a crush injury.

52-year-old male, chief rigger for a music festival, brought in by EMS after a speaker tower fell on his left side. EMS reports isolated trauma to the left chest with obvious multiple rib fractures. Received 50mcg of Fentanyl in the field.

TraumaThoracic +3 more
Patient Ed Gellin exhibiting profound diaphoresis (heavy sweating) and a distressed, anxious affect. He is receiving supplemental oxygen via nasal cannula, with EKG leads placed on his chest.
S01E03 Brief
52 · Male

Ed Gellin

10/10 substernal chest pain, dyspnea, and diaphoresis.

Mr. Ed Gellin is a 52-year-old male with a significant past medical history of hypertension and hyperlipidemia. He arrived via EMS presenting with 20 minutes of acute onset, 10/10 substernal chest pain accompanied by dyspnea and profound diaphoresis. Field EKG flagged a Code STEMI.

CardiologySTEMI +2 more
Patient unresponsive in the passenger seat of a vehicle upon arrival at the ED.
S01E03 Moderate
Early 20s · Female

Jenna

Unresponsive; suspected overdose

Jenna is a college-aged female brought to the ED by her friend in a car after being found unresponsive. The friend reports she 'won't wake up'. Jenna later admits she was studying late and couldn't sleep, so she took 'half a Xanax' for the first time. The pill was clearly counterfeit and laced with fentanyl, leading to a life-threatening opioid overdose.

ToxicologyOverdose +3 more
Patient presenting with massive facial trauma and epistaxis after an e-scooter collision.
S01E02 Brief
23 · Male

Ben Kemper

Facial trauma, neck contusion, and hemoptysis following a high-mechanism e-scooter crash.

23-year-old male arrives via EMS after getting 'doored' while riding an e-scooter without a helmet. Mechanism of injury involves his neck striking the handlebar, followed by a face-plant onto the pavement. He complains of blood pooling in the back of his throat.

TraumaAirway Management +2 more
Patient presenting to the trauma bay with a severe high-voltage electrical burn to the left forearm.
S01E02 Brief
Adult · Male

Unknown

High-voltage electrocution and ventricular fibrillation

Adult male brought in by flight crew after sustaining a high-voltage electrical injury to his left forearm. He was found at an abandoned factory with bolt cutters at his side, suggesting he cut into a live wire while attempting to steal copper. Pre-hospital course was complicated by a witnessed ventricular fibrillation (V-fib) arrest requiring at least one defibrillation shock prior to ED arrival.

TraumaEnvironmental +3 more
Worried Parents of the Patient
S01E02 Complex
18 · Male

Nick Bradley

Found unresponsive in bed by parents

18-year-old college student found unresponsive in his bed by his mother. No known medical history, no daily medications, no known allergies. Found barely breathing with pinpoint pupils and a heart rate of 38. Prehospital EMS administered Narcan which improved pupillary response, but the patient failed to breathe spontaneously and required endotracheal intubation. No obvious signs of trauma, and no drugs or alcohol were reported on the scene. Later collateral history from a classmate revealed he had volunteered to pick up illicit 'Xanax' for a study group to help them sleep, confirming a counterfeit pill ingestion resulting in a massive fentanyl overdose.

ToxicologyOverdose +4 more
Elderly male patient presenting with confusion and fever.
S01E01 Complex
79 · Male

Joseph Spencer

Fever and cough

79-year-old male from an assisted living facility presenting to the ED with a fever and cough. He has a history of mild Alzheimer's disease. On arrival, he is tachycardic, hypotensive, and experiencing altered mental status (asking if it is dinnertime). A POLST form from his facility indicates he is to receive IV fluids and medications, but no intubation and no chest compressions (DNI/No CPR).

Infectious DiseaseSepsis +7 more
Otis Williams presenting in triage.
S01E01 Complex
31 · Male

Otis Williams

Shortness of breath and severe fatigue after attempting a morning run.

A 31-year-old healthy male presents with shortness of breath and severe fatigue. He reports feeling fine until about two weeks ago, following the Rochester Marathon. He frequently participates in triathlons. Attempted to run this morning but had to quit after one minute due to dyspnea. No recent falls, injuries, or previous medical issues reported.

CardiologyNephrology +3 more