CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 75 year-old female who
was transferred to the [**Hospital1 69**]
after falling approximately 13 steps down stairs.  She was
found unconscious and unresponsive at the scene by EMS at
which time she was intubated.  Her [**Location (un) 2611**] Coma Scale at the
scene was 3.  She was transferred to the [**Hospital1 346**] by Med-Flight and upon arrival was
intubated and sedated.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subarachnoid hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level,Traumatic pneumothorax without mention of open wound into thorax,Hyposmolality and/or hyponatremia,Closed fracture of sixth cervical vertebra,Accidental fall on or from other stairs or steps,Personal history of malignant neoplasm of large intestine,Unspecified essential hypertension
Subarach hem-deep coma,Traum pneumothorax-close,Hyposmolality,Fx c6 vertebra-closed,Fall on stair/step NEC,Hx of colonic malignancy,Hypertension NOS
Admission Date:  [**2165-3-29**]       Discharge Date:  [**2165-4-8**]

Date of Birth:   [**2102-1-23**]       Sex:  F

Service:

ADMTTING DIAGNSOIS:
Trauma.

HISTORY OF PRESENT ILLNESS:  This is a 75 year-old female who
was transferred to the [**Hospital1 69**]
after falling approximately 13 steps down stairs.  She was
found unconscious and unresponsive at the scene by EMS at
which time she was intubated.  Her [**Location (un) 2611**] Coma Scale at the
scene was 3.  She was transferred to the [**Hospital1 346**] by Med-Flight and upon arrival was
intubated and sedated.

Her examination was significant for 1 mm pupils bilaterally.
Her trachea was midline.  Her chest was clear to auscultation
bilaterally.  Her examination was regular rate and rhythm.
Her abdomen was soft, nontender, nondistended, with multiple
surgical scars.  Extremities:  she had a right foot
transmetatarsal amputation.  Emergency Room rectal
examination showed normal tone.  Heme negative.  She
underwent a chest x-ray that demonstrated no  pneumothorax or
rib fractures.  She underwent a plain film of the pelvis
which showed no evidence of fractures.  Her CT scan of the
head demonstrated a large traumatic subarachnoid bleed with
mild midline shift.  Her abdomen and pelvis CT was negative
for any gross traumatic abnormalities as was the CT of the
chest.   She had laboratory values sent at the time which
were significant for a white count of 5.6, hematocrit of 32
and platelets of 214.  Her coagulation studies were normal
with an INR of 1.0 and a PTT of 26.7.  Her blood gas was
significant for the following values - a pH of 7.36, pCO2 of
35, pO2 of 282, bicarbonate of 21 and a base excess of -4.

Upon speaking with the family her past medical history was
significant for a total abdominal hysterectomy.  She had
colon cancer, status post resection.  She had a right
transmetatarsal amputation.  She had an allergy to Compazine.
Her medications at home included Effexor, Diovan,
hydrochlorothiazide, trazodone.

She was transferred to the Trauma Intensive Care Unit after a
neurosurgical consult was obtained and a right
ventriculostomy drain was placed at the bedside under sterile
conditions.  Her ICPs were found to be in the 10 to 20 range.
At this point she was treated aggressively with labetalol to
maintain a cerebral perfusion pressure of greater than 70 and
she was treated with a ventriculostomy drain to main an ICP
of less than 20.  Despite aggressive management over the next
several days her neurological status did not improve.  She
would be taken off sedation at least once a day for sedation
holiday and demonstrated no purposeful movement.  She had
extensor posturing of the upper extremities and repeat head
CT confirmed traumatic subarachnoid hemorrhage and MRI of the
head was obtained which demonstrated no evidence for acute
infarction.  The patient was transferred to the neurosurgical
service and after over a week of aggressive treatment her
family felt that she would not make a meaningful recovery and
after meeting with the Intensive Care Unit team they withdrew
support on [**2165-4-8**].  The patient expired on [**4-8**].





                            [**Name6 (MD) 19851**] [**Name8 (MD) 19852**], M.D.  [**MD Number(1) 19853**]

Dictated By:[**Name8 (MD) 4720**]
MEDQUIST36

D:  [**2165-5-17**]  08:31
T:  [**2165-5-17**]  08:53
JOB#:  [**Job Number 30539**]
{'Subarachnoid hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level,Traumatic pneumothorax without mention of open wound into thorax,Hyposmolality and/or hyponatremia,Closed fracture of sixth cervical vertebra,Accidental fall on or from other stairs or steps,Personal history of malignant neoplasm of large intestine,Unspecified essential hypertension'}


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 75 year-old female who
was transferred to the [**Hospital1 69**]
after falling approximately 13 steps down stairs.  She was
found unconscious and unresponsive at the scene by EMS at
which time she was intubated.  Her [**Location (un) 2611**] Coma Scale at the
scene was 3.  She was transferred to the [**Hospital1 346**] by Med-Flight and upon arrival was
intubated and sedated.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subarachnoid hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level,Traumatic pneumothorax without mention of open wound into thorax,Hyposmolality and/or hyponatremia,Closed fracture of sixth cervical vertebra,Accidental fall on or from other stairs or steps,Personal history of malignant neoplasm of large intestine,Unspecified essential hypertension'}
