CHIEF COMPLAINT: 64M struck by bus @ 35mph, ?LOC, found A&Ox3. Significant front
end damage to bus.

PRESENT ILLNESS: 64M s/p ORIF for miminally displaced medial orbital wall
fracture and blow-out of inferior wall with some herniation of
EOM. s/p ped vs bus. +LOC. Communited [**Month/Year (2) **] tib/fib fx and
fx/dislocation of right radius/wrist. L upper eyelid lac
repaired in ER. CT with . Globe intact, seen by ophtho, no
retroorbital hematoma.

MEDICAL HISTORY: 1. Diverticulitis-hospitalized at age 22; since then has been
compliant with low residue diet and has had only two
exacerbations both treated as an outpatient

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: LUNGS DECRASE SOUND BILATERALY
HEART RR
ABD OBESE
EXT EDEMA +
CNS FOLLOW COMMANDS MAE

FAMILY HISTORY: History of colon cancer.

SOCIAL HISTORY: Lives with his wife in the [**Location (un) 4398**]. Works as a lawyer. [**Name (NI) **] two
children and one grandchild. Never smoked. Drinks occasionally.
Closed fracture of shaft of fibula with tibia,Closed fracture of orbital floor (blow-out),Chronic airway obstruction, not elsewhere classified,Concussion, with loss of consciousness of 30 minutes or less,Urinary tract infection, site not specified,Bacteremia,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Other closed fractures of distal end of radius (alone),Laceration of skin of eyelid and periocular area,Injury to other gastrointestinal sites, without mention of open wound into cavity,Conjunctival edema,Unspecified sleep apnea,Morbid obesity
Fx shaft fib w tib-clos,Fx orbital floor-closed,Chr airway obstruct NEC,Concus-brief coma <31 mn,Urin tract infection NOS,Bacteremia,Mv coll w pedest-pedest,Fx distal radius NEC-cl,Lac eyelid skn/perioculr,GI injury NEC-closed,Conjunctival edema,Sleep apnea NOS,Morbid obesity
Admission Date:  [**2122-10-30**]              Discharge Date:   [**2122-11-17**]

Date of Birth:  [**2058-6-12**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1556**]
Chief Complaint:
64M struck by bus @ 35mph, ?LOC, found A&Ox3. Significant front
end damage to bus.


Major Surgical or Invasive Procedure:
TRACHEOSTOMY
[**10-30**]: s/p ORIF L tib/fib, ORIF R wrist


History of Present Illness:
64M s/p ORIF for miminally displaced medial orbital wall
fracture and blow-out of inferior wall with some herniation of
EOM. s/p ped vs bus. +LOC. Communited [**Month/Year (2) **] tib/fib fx and
fx/dislocation of right radius/wrist. L upper eyelid lac
repaired in ER. CT with . Globe intact, seen by ophtho, no
retroorbital hematoma.

CXR supine: widened mediastinum
Pelvis: neg
CT head: loss of grey-white diff in L temporal lobe (?final
read)
CT face: Nasal fractures, medial and inferior left orbit
fractures
CT c-spine: Ossicle anterior to Odontoid-likely old but cannot
rule out acute fx, C5 R transversarium arterial calcification
vs. bony fragment-c collar cleared by ortho spine
Flex ex: neg
CT chest: no mediast hematoma/bleeding, left thyroid nodule
CT abd/pelvis: 7.4cm mesenteric hematoma (no extrav), L renal
artery stranding
Left leg: Proximal tib/fib fx, comminuted, minimally displaced;
s/p ORIF [**10-30**]
Left Shoulder:
Right Hand: Posterior wrist displacement w/ R distal radius fx
s/p ORIF [**10-30**]
.


Past Medical History:
1. Diverticulitis-hospitalized at age 22; since then has been
compliant with low residue diet and has had only two
exacerbations both treated as an outpatient

2. Left buttock injury with infection secondary to being hit by
a car four years ago. Patient was crossing street and was hit
with a resulting large left buttock wound. Also with knee
infection. Treated at [**Hospital1 2177**].


Social History:
Lives with his wife in the [**Location (un) 4398**]. Works as a lawyer. [**Name (NI) **] two
children and one grandchild. Never smoked. Drinks occasionally.


Family History:
History of colon cancer.

Physical Exam:
LUNGS DECRASE SOUND BILATERALY
HEART RR
ABD OBESE
EXT EDEMA +
CNS FOLLOW COMMANDS MAE

Pertinent Results:
CXR supine: widened mediastinum
Pelvis: neg
CT head: loss of grey-white diff in L temporal lobe (?final
read)
CT face: Nasal fractures, medial and inferior left orbit
fractures
CT c-spine: Ossicle anterior to Odontoid-likely old but cannot
rule out acute fx, C5 R transversarium arterial calcification
vs. bony fragment-c collar cleared by ortho spine
Flex ex: neg
CT chest: no mediast hematoma/bleeding, left thyroid nodule
CT abd/pelvis: 7.4cm mesenteric hematoma (no extrav), L renal
artery stranding
Left leg: Proximal tib/fib fx, comminuted, minimally displaced;
s/p ORIF [**10-30**]
Left Shoulder:
Right Hand: Posterior wrist displacement w/ R distal radius fx
s/p ORIF [**10-30**]
pos bd and uc for e coli/on levofloaxine (14 days treatment)

Brief Hospital Course:
64M s/p ORIF for minimally displaced medial orbital wall
fracture and blow-out of inferior wall with some herniation of
EOM. s/p PED vs bus. +LOC. Communi [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] TIB/fib FX and
FX/dislocation of right radius/wrist. L upper eyelid lac
repaired in ER. CT with . Globe intact, seen by Ophth, no retro
orbital hematoma.
Patient required intubation for aspiration and respiratory
failure. Previous antecedent of sleep apnea, COPD, and
restrictive lung disease.
Got a tracheostomy 7 days prior to DC.
On vent ps and peep 14/14.
Needs vent rehab.

Discharge Medications:
1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed for pain/fever.
2. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
Injection ASDIR (AS DIRECTED).
3. Artificial Tear Ointment 0.1-0.1 % Ointment Sig: One (1) Appl
Ophthalmic  PRN (as needed).
4. Albuterol 90 mcg/Actuation Aerosol Sig: Two (2) Puff
Inhalation Q4H (every 4 hours).
5. Ipratropium Bromide 18 mcg/Actuation Aerosol Sig: Two (2)
Puff Inhalation Q6H (every 6 hours).
6. Enoxaparin 60 mg/0.6mL Syringe Sig: One (1)  Subcutaneous
Q12H (every 12 hours).
7. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1)  PO BID (2
times a day).
8. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal
DAILY (Daily) as needed.
9. Erythromycin 5 mg/g Ointment Sig: One (1)  Ophthalmic  QID (4
times a day).
10. Peppermint Spirit     Spirit Sig: One (1)  PO PRN (as
needed) as needed for odor.
11. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID
(4 times a day) as needed.
12. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
13. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO
TID (3 times a day).
14. Haloperidol Lactate 5 mg/mL Solution Sig: One (1)  Injection
Q4H (every 4 hours) as needed.
15. Morphine 2 mg/mL Syringe Sig: One (1)  Injection Q2H (every
2 hours) as needed.
16. Lorazepam 2 mg/mL Syringe Sig: One (1)  Injection Q4H (every
4 hours) as needed.
17. Levofloxacin in D5W 500 mg/100 mL Piggyback Sig: One (1)
Intravenous  Q24H (every 24 hours) for 14 days.


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 672**] Hospital

Discharge Diagnosis:
SP PEDESTRIAN VRS CAR


Discharge Condition:
STABLE/GOOD


Discharge Instructions:
VENTILATOR AS PER [**Hospital **] REHAB
TUBE FEEDING AS ORDER
TRACHEOSTOMY CARE
14 days in iv levofloxacin

Followup Instructions:
[**Last Name (LF) **],[**First Name3 (LF) **] E.  in 4 weeks or call with [**Name6 (MD) 38588**] [**Name8 (MD) 38589**], M.D. [**MD Number(1) 38590**] ([**Telephone/Fax (1) 2047**] E/SCC-3   E/TCC 3 General
[**Doctor First Name **] [**Hospital1 18**]



Completed by:[**2122-11-17**]
{'Closed fracture of shaft of fibula with tibia,Closed fracture of orbital floor (blow-out),Chronic airway obstruction, not elsewhere classified,Concussion, with loss of consciousness of 30 minutes or less,Urinary tract infection, site not specified,Bacteremia,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Other closed fractures of distal end of radius (alone),Laceration of skin of eyelid and periocular area,Injury to other gastrointestinal sites, without mention of open wound into cavity,Conjunctival edema,Unspecified sleep apnea,Morbid obesity'}


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: 64M struck by bus @ 35mph, ?LOC, found A&Ox3. Significant front
end damage to bus.

PRESENT ILLNESS: 64M s/p ORIF for miminally displaced medial orbital wall
fracture and blow-out of inferior wall with some herniation of
EOM. s/p ped vs bus. +LOC. Communited [**Month/Year (2) **] tib/fib fx and
fx/dislocation of right radius/wrist. L upper eyelid lac
repaired in ER. CT with . Globe intact, seen by ophtho, no
retroorbital hematoma.

MEDICAL HISTORY: 1. Diverticulitis-hospitalized at age 22; since then has been
compliant with low residue diet and has had only two
exacerbations both treated as an outpatient

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: LUNGS DECRASE SOUND BILATERALY
HEART RR
ABD OBESE
EXT EDEMA +
CNS FOLLOW COMMANDS MAE

FAMILY HISTORY: History of colon cancer.

SOCIAL HISTORY: Lives with his wife in the [**Location (un) 4398**]. Works as a lawyer. [**Name (NI) **] two
children and one grandchild. Never smoked. Drinks occasionally. 

### Response:
{'Closed fracture of shaft of fibula with tibia,Closed fracture of orbital floor (blow-out),Chronic airway obstruction, not elsewhere classified,Concussion, with loss of consciousness of 30 minutes or less,Urinary tract infection, site not specified,Bacteremia,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Other closed fractures of distal end of radius (alone),Laceration of skin of eyelid and periocular area,Injury to other gastrointestinal sites, without mention of open wound into cavity,Conjunctival edema,Unspecified sleep apnea,Morbid obesity'}
