CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 64-year-old female
transferred from [**Hospital3 **] status post MVC versus pole
with positive loss of consciousness. The patient was
restrained and airbag was deployed. GCS was 15,
hemodynamically stable, open fracture in the left forearm
noted. She denies chest pain or shortness of breath. The
patient was taken to the Operating Room by Orthopedics from
the Emergency Room. The patient was then admitted to the
Intensive Care Unit for overnight monitoring.

MEDICAL HISTORY: Acute renal failure during last
medical admission which is now resolved. Hypothyroidism. High
blood pressure. Psoriasis. Hypercholesterolemia. Urinary
tract infection.

MEDICATION ON ADMISSION: 

ALLERGIES: Questionable to Levaquin and questionable to
Benadryl.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Concussion with loss of consciousness of unspecified duration,Flail chest,Other open fractures of distal end of radius (alone),Acidosis,Injury to other specified intrathoracic organs without mention of open wound into cavity,Precipitous drop in hematocrit,Other injury of abdomen,Open wound of abdominal wall, lateral, without mention of complication,Open wound of knee, leg [except thigh], and ankle, without mention of complication
Concussion w coma NOS,Flail chest,Fx distal radius NEC-opn,Acidosis,Intrathoracic inj NEC-cl,Drop, hematocrit, precip,Injury of abdomen NEC,Opn wnd lateral abdomen,Open wnd knee/leg/ankle
Admission Date: [**2101-5-18**]        Discharge Date: [**2101-5-27**]

Date of Birth:  [**2037-4-15**]        Sex:  F

Service:  TRA


ADMISSION DIAGNOSIS:  Status post motor vehicle accident.

HISTORY OF PRESENT ILLNESS:  This is a 64-year-old female
transferred from [**Hospital3 **] status post MVC versus pole
with positive loss of consciousness. The patient was
restrained and airbag was deployed. GCS was 15,
hemodynamically stable, open fracture in the left forearm
noted. She denies chest pain or shortness of breath. The
patient was taken to the Operating Room by Orthopedics from
the Emergency Room. The patient was then admitted to the
Intensive Care Unit for overnight monitoring.

PAST MEDICAL HISTORY:  Acute renal failure during last
medical admission which is now resolved. Hypothyroidism. High
blood pressure. Psoriasis. Hypercholesterolemia. Urinary
tract infection.

PAST SURGICAL HISTORY:  Cholecystectomy.

MEDICATIONS:
1. Synthroid 150 mcg q d.
2. Lipitor 10 mg q d.
3. ACE inhibitor which was started on the day of the
   accident.
4. Aspirin 325 mg q d.
5. Multivitamin.
6. Amoxicillin 500 mg t.i.d., day three of five day course
   for urinary tract infection.


ALLERGIES:  Questionable to Levaquin and questionable to
Benadryl.

LABORATORY DATA:  Imaging done at the time of admission from
the outside hospital on [**2101-5-18**] includes a CT of the head
which was negative. Outside hospital CT of the C-spine was
negative. Outside hospital CT of the chest showed rib
fractures of six, seven and eight, bilateral lower pleural
effusions, no pneumothorax. Outside hospital CT of the
abdomen and pelvis showed no apparent injuries to the
mesentery, no solid organ injury, subcutaneous hematoma in
the area of the left ASIS extending across the lower
abdominal wall. Outside hospital left wrist x-ray showed a
distal radial fracture, comminuted, open.

Imaging done in the Operating Room at this hospital on
[**2101-5-18**] included fluoro of right lower extremity which
showed no fractures. CT of the abdomen and pelvis was
repeated, which revealed possible transverse process
fractures of the L1 to L4. [**2101-5-19**] TLS plain films were
negative. Chest x-ray on [**2101-5-22**] showed small pleural
effusions.

Labs at the time of admission showed a white blood cell count
of 20.2, hematocrit 42.1, platelets 373 from the outside
hospital. Sodium 139, potassium 4.0, chloride 102,
bicarbonate 25, glucose 147, INR 1.3, lactate 3.7.

HOSPITAL COURSE:  from the Emergency Department, the patient
underwent open reduction, internal fixation of the left
distal radius fracture with external fixation. The patient
was then admitted to the Intensive Care Unit for monitoring
postoperatively. Overnight, the patient had a hematocrit drop
of 39.1 to 32.5. Consequent serial hematocrit, however,
remained staple in the high 20s for the remainder of the
hospital stay. The patient also remained clinically
asymptomatic. Vital signs remained stable. The patient was
transferred to the floor on hospital day four.

Upon reaching the floor, the patient's course was largely
unremarkable. The patient underwent Physical Therapy and
Occupational Therapy evaluation. The patient was deemed ready
for discharge to rehabilitation versus home. Upon discussion
with the family and the patient, the patient was discharged
to rehabilitation in stable condition.

PROCEDURES PERFORMED:  Open reduction, internal fixation with
external fixation on [**2101-5-18**]; please see Operative Note
for further details. Echocardiogram on [**2101-5-25**], which was
unremarkable. Bilateral ultrasound of the carotids, which
showed no stenosis noted. Electroencephalogram on [**2101-5-25**]
was unremarkable.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  To rehabilitation.

DISCHARGE DIAGNOSES:  Concussion.

Right rib fractures of six, seven and eight with flail
segment.

Open left distal radius fracture, comminuted, status post
open reduction, internal fixation with external fixation.

Soft injury chest to abdomen.

Superficial laceration to left inguinal fold.

Soft tissue injury to right lower extremity which were closed
in the Operating Room status post fluoro exploration.

DISCHARGE MEDICATIONS:
1. Percocet 5/325 mg 1-2 tablets p.o. q 4-6 hours p.r.n.
   pain.
2. Zofran 8 mg p.o. q eight hours p.r.n. nausea.
3. Atorvastatin 10  mg q d.
4. Levothyroxine 150 mcg q d.
5. Vioxx 25 mg q d.
6. Colace 100 mg b.i.d.


FOLLOW UP:  The patient will follow-up in the Trauma Clinic
in one week. The patient will follow-up with Dr. [**Last Name (STitle) 9694**] in
two weeks. The patient will follow-up with primary care
physician in one week at which time the patient will also
have her stitches removed.



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], [**MD Number(1) 13037**]

Dictated By:[**Last Name (NamePattern1) 27758**]
MEDQUIST36
D:  [**2101-5-26**] 08:43:18
T:  [**2101-5-26**] 09:55:47
Job#:  [**Job Number **]


Name:  [**Known lastname 14831**], [**Known firstname **]              Unit No:  [**Numeric Identifier 14832**]

Admission Date: [**2101-5-3**]        Discharge Date: [**2101-5-30**]

Date of Birth:  [**2037-4-15**]        Sex:  F

Service:


ADDENDUM:  The patient's date of discharge was extended to
[**2101-5-30**].  There were no further medical issues which arose
during the extension of the hospital stay.  The patient's
vital signs remained stable and physical exam continued to
improve.  The [**Hospital 1325**] hospital course was prolonged
completely by social circumstances which prohibited the
patient from being discharged to home.  The patient could not
be discharged to a rehab center due to there being no medical
issues and also insurance issues.

On the day of discharge, the patient's vital signs were
within normal range.  The patient no longer required
supplemental oxygen, and the patient was ambulating freely
without any assistance.  The patient was discharged to home.
Follow up with PCP, [**Name10 (NameIs) 8078**], and trauma clinic as
indicated on discharge form.



                DR [**First Name11 (Name Pattern1) 389**] [**Initial (NamePattern1) **] [**Last Name (NamePattern1) **] 02.349

Dictated By:[**Last Name (NamePattern1) 14833**]
MEDQUIST36
D:  [**2101-5-30**] 12:20:18
T:  [**2101-5-31**] 02:54:01
Job#:  [**Job Number 14834**]
{'Concussion with loss of consciousness of unspecified duration,Flail chest,Other open fractures of distal end of radius (alone),Acidosis,Injury to other specified intrathoracic organs without mention of open wound into cavity,Precipitous drop in hematocrit,Other injury of abdomen,Open wound of abdominal wall, lateral, without mention of complication,Open wound of knee, leg [except thigh], and ankle, without mention of complication'}


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 a 64-year-old female
transferred from [**Hospital3 **] status post MVC versus pole
with positive loss of consciousness. The patient was
restrained and airbag was deployed. GCS was 15,
hemodynamically stable, open fracture in the left forearm
noted. She denies chest pain or shortness of breath. The
patient was taken to the Operating Room by Orthopedics from
the Emergency Room. The patient was then admitted to the
Intensive Care Unit for overnight monitoring.

MEDICAL HISTORY: Acute renal failure during last
medical admission which is now resolved. Hypothyroidism. High
blood pressure. Psoriasis. Hypercholesterolemia. Urinary
tract infection.

MEDICATION ON ADMISSION: 

ALLERGIES: Questionable to Levaquin and questionable to
Benadryl.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Concussion with loss of consciousness of unspecified duration,Flail chest,Other open fractures of distal end of radius (alone),Acidosis,Injury to other specified intrathoracic organs without mention of open wound into cavity,Precipitous drop in hematocrit,Other injury of abdomen,Open wound of abdominal wall, lateral, without mention of complication,Open wound of knee, leg [except thigh], and ankle, without mention of complication'}
