The pilot for the popular TV series is set during 24 frantic hours in the lives of a group of doctors, nurses, and staff members of a busy emergency room at a Chicago hospital. They deal with the seemingly endless casualties that stumble into their place of employment. The central characters are the chief resident and family man Dr. Mark Greene, who is considering a job in private practice due to pressure from his demanding law student wife Jennifer; outgoing Dr. Doug Ross, who deals with cases in his own personal way; straight-arrow Dr. Susan Lewis, trying to get by another long 36-hour shift; inexperienced third-year med student John Carter; cocky surgical resident Dr. Peter Benton; and troubled chief nurse Carol Hathaway.

The ER staff's slow snow day becomes chaotically hectic when the casualties of a 40 car traffic accident flood in.