The Pitt Season 1 Episode 1

Emergency Medicine Case Files & Clinical Analysis

Every emergency department patient from Season 1 Episode 1 of The Pitt, charted with medically accurate clinical documentation, diagnostic workups, and expert clinical pearls.

Episode

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Specialty

Showing 15 of 15 cases

EMS arriving with 89-year-old patient undergoing active CPR.

Unknown

Cardiac Arrest (Ventricular Fibrillation)

89-year-old female resident of a skilled nursing facility (SNF) with a past medical history of emphysema, congestive heart failure (CHF), and multiple sclerosis (MS). She was found in cardiac arrest at the facility. EMS found her in ventricular fibrillation (V-fib). Prior to ED arrival, she was unresponsive to three defibrillation shocks and two rounds of epinephrine. She was brought in as a 'full code' because the SNF staff was overwhelmed and unable to locate her advanced directive/DNR paperwork.

Cardiac ArrestResuscitation +3 more

Facial trauma presenting with avulsion of maxillary central incisor (Tooth #8).

Charlie

Facial trauma and missing tooth following a bar altercation.

Patient presents to the ED following a bar fight. He sustained blunt facial trauma resulting in the complete avulsion of tooth number eight. Patient was initially evaluated, deemed stable, and prepped for discharge before the unaccounted missing tooth was noted during morning rounds.

TraumaDental +2 more

Dennis Whitaker experiencing a finger injury during a code blue.

Dennis Whitaker

Acute finger pain and throbbing

Dennis Whitaker, a 4th-year medical student (MS4) on his first day in the Emergency Department, was participating in the resuscitation of an 89-year-old female patient in cardiac arrest. While assisting the team in transferring the patient from the gurney to the ED bed, he sustained a pinch or crush injury to his finger, which subsequently developed into a painful subungual hematoma.

Occupational InjuryOrthopedics +2 more

Elderly male patient presenting with confusion and fever.

S01E01 Moderate

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 +4 more

Patient presenting with severe intoxication.

Louie Cloverfield

Tolerant Severe Alcohol Intoxication

Louie Cloverfield is a known patient to the ED who presented at 11:00 PM the previous night with a potentially lethal blood alcohol content (BAC) of 0.420. Due to severe chronic alcohol tolerance, he survived the acute intoxication and is currently sobering up. He is now being evaluated for acute alcohol withdrawal.

ToxicologyAddiction Medicine +1 more

Patient with Right Lower Leg Degloving Injury

Adult · Female

Minu Agrawal

Extremity trauma and severe pain after falling onto subway tracks.

Patient fell from a subway 'T' platform and her foot was caught between the platform and an incoming train, resulting in a severe degloving injury and open fracture dislocation of the right lower leg and ankle. The mechanism of the fall is initially unknown; bystanders report she may have fainted, tripped, or been pushed. She was rescued by a Good Samaritan who sustained a head injury in the process. Patient presents with extreme pain refractory to initial opiate administration and an inability to provide history due to a profound language barrier.

TraumaOrthopedics +2 more

Mr. Milton in the ED Exam Room

S01E01 Moderate

Bennet Milton

Upper abdominal pain

Patient awoke at 2:00 AM with intense upper abdominal pain that lasted approximately one hour and subsequently resolved. He reports eating a heavy, fatty meal (steak at Sullivan's) for his wife's birthday the night prior. He denies fever or vomiting. He has a history of hypertension but forgot to take his morning enalapril.

GastroenterologyPOCUS +4 more

Otis Williams presenting in triage.

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

Patient arriving via EMS with LMA in place.

S01E01 Moderate

Sam Wallace

Blunt head trauma with agonal respirations after fall onto subway tracks.

42-year-old male brought in by EMS. Jumped onto the T (subway) tracks to rescue a woman who had fallen. After successfully pulling her off the tracks, he slipped while climbing back up the platform, fell backward, and struck his head. EMS noted agonal respirations. They were unable to intubate in the field and placed an LMA (Laryngeal Mask Airway) prior to transport.

TraumaNeurology +1 more

Patient awaiting surgical consult for SBO.

S01E01 Moderate

Unknown

Abdominal pain, lack of bowel movements (Small Bowel Obstruction)

Patient presented overnight with symptoms suggestive of a small bowel obstruction (SBO). He has been boarding in the emergency department for over three hours waiting for a surgical consult. Initial conservative management with magnesium citrate to stimulate bowel activity failed.

GastroenterologyGeneral Surgery

Thermal burn to the anterior hand

30s-40s · Female

Sherry

Burn to the hand

Patient presents to the ED after sustaining a thermal burn to her hand from a Sterno can while allegedly making s'mores with her son. She has been waiting in the ED for hours and is anxious to leave to take her children to school.

BurnWound Care +2 more

Patient presenting with severe intractable vomiting and dehydration.

S01E01 Moderate

Theresa

Intractable vomiting

54-year-old female brought to the ED by her 18-year-old son, David. Patient was found on the bathroom floor and has had intractable vomiting since last night. Denies prior stomach problems, new medications, or recent travel. Husband passed away a few years ago from COVID-19.

ToxicologyPsychiatry +2 more

Lethargic 4-year-old male upon ED arrival.

S01E01 Moderate

Tyler Jones

Lethargic and Unarousable 4-year-old boy brought to the ED by his parents.

4-year-old male with no past medical history, no antecedent illness, no fever, and no vomiting. Brought to the ED because his parents could not wake him up in the morning. Usually a highly active child. No apparent access to locked medications, no known trauma, and no sick contacts at his preschool.

PediatricsToxicology +1 more

MS3 Victoria Javadi collapsing in the trauma bay.

S01E01 Moderate

Victoria Javadi

Syncope during a medical procedure

Victoria Javadi is a 20-year-old third-year medical student (MS3) on her first day of clinical rotation in the Emergency Department. While observing a closed reduction of a gruesome Type 3 open fracture and degloving injury in the trauma bay, she experienced a sudden loss of consciousness and fell to the floor. Upon regaining consciousness, she initially denied fainting, claiming she tripped over a gurney. She was subsequently evaluated by the attending physician and sent to the staff lounge to recover.

SyncopeVasovagal +2 more

Left shoulder with entry wound from 9mm gunshot.

Virgil Straker

Gunshot wound to the left shoulder

Patient sustained a 9mm gunshot wound to the left shoulder. He was evaluated overnight. CT angiogram was negative for vascular injury. The surgical team requested overnight observation, and he has been boarding in the ED.

TraumaGunshot Wound +1 more