CHIEF COMPLAINT: 

PRESENT ILLNESS: This is an 18-year-old female
who arrived to [**Hospital1 69**] via
Med-Flight who had been found near her home on the side of
the rode next to her bicycle, unresponsive, with a small
laceration to her right temple.  The patient was had stable
vital signs at the scene; however, she was unresponsive with
[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 2611**] Coma Scale of 3 to 5; documentation unclear.

MEDICAL HISTORY: The patient has no significant past
medical history (per subsequent interview when the patient
was awake).

MEDICATION ON ADMISSION: The patient takes no medications
on a daily basis.

ALLERGIES: The patient has no known drug allergies

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her family at home
and is planning on going to veterinarian school.  No ethanol
or recreational drug use.
Open wound of scalp, without mention of complication,Pedal cycle accident injuring pedal cyclist
Open wound of scalp,Ped cycl acc-ped cyclist
Admission Date:  [**2108-6-19**]     Discharge Date:  [**2108-6-20**]

Date of Birth:   [**2089-6-9**]     Sex:  F

Service:  CICU

ADMISSION DIAGNOSIS:  Status post trauma.

DISCHARGE DIAGNOSIS:  Closed head injury with laceration.

HISTORY OF PRESENT ILLNESS:  This is an 18-year-old female
who arrived to [**Hospital1 69**] via
Med-Flight who had been found near her home on the side of
the rode next to her bicycle, unresponsive, with a small
laceration to her right temple.  The patient was had stable
vital signs at the scene; however, she was unresponsive with
[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 2611**] Coma Scale of 3 to 5; documentation unclear.

Per Emergency Medical Service, the patient evacuated by
helicopter to [**Hospital1 69**] Emergency
Department.  In transit, she vomited and was subsequently
intubated to protect her airway given her mental status.

On arrival to the Emergency Department at [**Hospital1 346**], the patient was intubated status
post sedation.

PAST MEDICAL HISTORY:   The patient has no significant past
medical history (per subsequent interview when the patient
was awake).

MEDICATIONS ON ADMISSION:  The patient takes no medications
on a daily basis.

ALLERGIES:  The patient has no known drug allergies

SOCIAL HISTORY:  The patient lives with her family at home
and is planning on going to veterinarian school.  No ethanol
or recreational drug use.

REVIEW OF SYSTEMS:   Review of systems was essentially
negative with no fevers, chills, nausea, vomiting, abdominal
pain, or bright red blood per rectum.  No neurologic
complaints.  The patient reports no previous episodes of
seizures, syncope, or spontaneous loss of consciousness in
the past.

PHYSICAL EXAMINATION ON PRESENTATION:  Physical examination
at that time revealed her heart rate to be 60, her blood
pressure was 114/34, saturating 100%.  The patient was
intubated.  Pupils were equal, round, and reactive to light
bilaterally from 4 mm to 2 mm.  The trachea was midline, and
cervical collar was in place.  The chest had clear breath
sounds bilaterally.  Cardiovascular examination revealed a
regular rate and rhythm.  No murmurs, rubs or gallops.  The
abdomen was soft, nontender, and nondistended. Rectal
examination revealed no blood, with slightly lax rectal tone.
 The chest and back examination revealed no deformities, to
crepitus, no vertebral stepoff throughout.  Extremities were
without deformities, moved all four spontaneously status post
sedation.

PERTINENT LABORATORY DATA ON PRESENTATION:  Pertinent
laboratories on the morning of admission revealed the patient
had a white blood cell count of 15.4, with a stable
hematocrit at 35.  Chem-7 was all within normal limits.
Coagulation studies were within normal limits.  Beta human
chorionic gonadotropin was negative.  The patient was
admitted to have a toxoid for her laceration.

HOSPITAL COURSE:   Blood gas in the Emergency Department
revealed a pH of 7.44, PCO2 of 32, PO2 of 211, bicarbonate of
22, and lactate of 1.9.  The patient had a small left
temporal laceration which was cleaned and repaired with three
3-0 nylon sutures.  The patient underwent numerous studies
(see below).  The patient was admitted to the Trauma
Cardiothoracic Intensive Care Unit in stable condition.

The patient was admitted and admitted to the Cardiothoracic
Intensive Care Unit for observation.  She self-extubated on
arrival to the floor.  She did well, breathing spontaneously
with a clear airway with an alert and oriented mental status.
No issues through the following morning.

In the Emergency Department, the patient underwent radiologic
evaluation including a head CT, chest x-ray, abdominal and
pelvic CT; all of which were negative.  A CT of the cervical
spine was negative as well.  The patient's collar was
removed, and her cervical spine clinically cleared.

On examination in the morning of hospital day one (and the
day of discharge), the patient's vital signs revealed a
temperature current of 37.8, a temperature maximum of 37.8,
blood pressure of 108/45, a heart rate of 83, breathing 17
times per minute with an oxygen saturation of 97% on room
air, and in no distress.  Physical examination revealed the
patient to be alert and oriented times three with a clear
sensorium.  Her heart was regular in rate and rhythm.  No
murmurs, rubs or gallops.  Her lungs were clear to
auscultation bilaterally.  Her abdomen was soft, nontender,
and nondistended, with positive bowel sounds.  Her
extremities were warm with palpable dorsalis pedis pulses and
posterior tibialis pulses.  She moved all extremities
spontaneously.  Neurologic examination revealed strength was
[**4-8**] throughout.  Cranial nerves II through XII were intact.
No sensory deficits.

DISCHARGE STATUS:  The patient was discharged to home on
[**6-20**] in stable condition.

DISCHARGE FOLLOWUP:   The patient was to follow up within one
week in the Trauma Clinic for suture removal and evaluation.
The patient was also given the [**Hospital 878**] Clinic and
instructed to follow up with Neurology as an outpatient for
evaluation for possible seizure given the unclear etiology of
her loss of consciousness; although, by history and
laceration, accidental fall and concussion with syncope
amnesia seemed like the most likely explanation.  Alternative
etiologies could not be excluded, and the patient was advised
to avoid driving and/or riding a bicycle, or engaging in any
other activities where loss of consciousness would be
dangerous until she follows up with Neurology within one
week. The above plans were discussed fully with the patient
and her family prior to discharge.

CONDITION AT DISCHARGE:  Condition on discharge was good.

DISCHARGE DISPOSITION:  Discharged to home.




                          [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D.

Dictated By:[**Name8 (MD) 20078**]

MEDQUIST36

D:  [**2108-6-20**]  15:28
T:  [**2108-6-25**]  09:29
JOB#:  [**Job Number 42739**]
{'Open wound of scalp, without mention of complication,Pedal cycle accident injuring pedal cyclist'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: This is an 18-year-old female
who arrived to [**Hospital1 69**] via
Med-Flight who had been found near her home on the side of
the rode next to her bicycle, unresponsive, with a small
laceration to her right temple.  The patient was had stable
vital signs at the scene; however, she was unresponsive with
[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 2611**] Coma Scale of 3 to 5; documentation unclear.

MEDICAL HISTORY: The patient has no significant past
medical history (per subsequent interview when the patient
was awake).

MEDICATION ON ADMISSION: The patient takes no medications
on a daily basis.

ALLERGIES: The patient has no known drug allergies

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her family at home
and is planning on going to veterinarian school.  No ethanol
or recreational drug use. 

### Response:
{'Open wound of scalp, without mention of complication,Pedal cycle accident injuring pedal cyclist'}
