The 8 Most Shocking 'ER' Moments Ever, From Prison Breaks To Ambulance Explosions

Warner Bros

It's hard to cherry-pick just a few surprise moments from a show centered entirely around not knowing what emergency will barrel through the door next, but ER managed to keep things lively for over 20 seasons. There were breakups, hookups, outbreaks, and explosions, not to mention hostage situations, life-or-death surgeries, and the occasional fainting spell. Still, in all those seasons of heart-dropping medical action, some points stand out, such as these eight totally shocking ER moments.

Though the show could occasionally veer into the purely ludicrous (Dr. Romano's death by flaming helicopter felt more like Wile E. Coyote than a medical procedural, as it took so long for the helicopter to come down on his oblivious head he could have held up a tiny sign that said HELP before it landed) the key to many of the series' shocks were rooting them in believability. ER was praised for being one of the first shows to try and depict medicinal practice realistically, instead of using it as a mere backdrop for melodrama and romance. Most of the biggest surprises came from putting beloved characters' lives on the line, something that wouldn't resonate with an audience unless they felt a real connection. Such as...


Prison Break

"Twenty-One Guns" (Season 12, Ep. 22) has a lot going on, but the swift combination of an E.R. shootout where Jerry gets shot and Sam gets kidnapped by her vicious ex, only to discover they've taken her son hostage as well, left viewers breathless catching up.


Discovering Lucy

"Be Still My Heart" (Season 6, Episode 13) has one of the show's most indelible moments, when fan favorite Dr. Carter is suddenly and violently stabbed by a mentally ill patient... only to discover when he falls to the floor he wasn't the first one attacked.


Amputation By Helicopter

Though Dr. Romano wasn't the most popular personality on the show, when his arm gets suddenly, outlandishly severed at the very start of Season 9 in "Chaos Theory", it left many fans gasping.


Beeper Shock

Dr. Benton was always a tough taskmaster, but he leaned too hard into surgical intern Dennis Gant. In this episode, when a patient who jumps in front of a train comes in, Dr. Benton rages and pages Grant, only for the entire E.R. to discover they've been working on one of their own.


Ambulance Explosion

Season 14 goes out with a literal bang when an ambulance explodes just after Dr. Greg Pratt enters. The cliffhanger certainly worked at the time the episode aired, keeping fans wondering for months whether Dr. Greg Pratt survived the successful attack on his Witness Protection patient's life.


Dr. Benton Is NOT The Father

In "Partly Cloudy, Chance of Rain" (Season 8, Episode 8), in the middle of a long, bitter custody battle following his ex-wife's death, Dr. Benton gets news that his son isn't biologically his. His fight's just doubled in difficulty, and it throws an unexpected wrench in his feelings.


Another Prison Break

"Twenty-One Guns" (Season 12, Ep. 22) got a mention earlier but this episode is truly bananas. Luka's still paralyzed from being stabbed with a syringe, and strapped to a gurney is unable to do anything but watch helplessly as he sees Abby bleeding, possibly having a miscarriage, and collapsing to the ground.


Death By Helicopter

Helicopters really and truly had it in for Dr. Romano. In "Freefall" (Season 10, Episode 8), a helicopter accident sets off a chain of events that reverberate throughout the episode. The accident is terrifying enough, with shards of metal flying and culminating in an E.R. explosion, but Romano's undignified death (with time to run away even!) had a lot of fans at the time supremely frustrated.

Most ER episodes weren't filled with this level of drama, but whenever an installment was punctuated by the kind of intense bursts listed above, you knew you were in for an experience.