CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 30-year-old male who
fell off his bike while in a race and he was going
approximately 25-30 miles per hour.  There was positive loss
of consciousness at the scene, approximately down for 5
minutes.  He was transferred to an outside hospital.  He was
found to have a small amount of subarachnoid hematoma.
However, his [**Location (un) 2611**] coma score was 15, and he was
transferred here for further evaluation.  He initially was
complaining of left shoulder pain.  There was no evidence of
hypoxia or hypotension on transfer.  Upon arrival to the
Emergency Department here at [**Hospital6 2018**] on the evening of [**2199-3-10**], basic trauma activation
ensued.  He was otherwise well up until the time of this
incident.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Denies alcohol or smoking.  He is single.
He has a significant other, female.  [**Name2 (NI) **] children.
Subarachnoid hemorrhage following injury without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Pedal cycle accident injuring pedal cyclist,Closed fracture of clavicle, unspecified part,Abrasion or friction burn of trunk, without mention of infection,Abrasion or friction burn of shoulder and upper arm, without mention of infection
Subarach hem-brief coma,Ped cycl acc-ped cyclist,Fx clavicle NOS-closed,Abrasion trunk,Abrasion shoulder/arm
Admission Date:  [**2199-3-10**]       Discharge Date:  [**2199-3-11**]

Date of Birth:   [**2168-10-2**]       Sex:  M

Service:  TRAUMA

HISTORY OF PRESENT ILLNESS:  This is a 30-year-old male who
fell off his bike while in a race and he was going
approximately 25-30 miles per hour.  There was positive loss
of consciousness at the scene, approximately down for 5
minutes.  He was transferred to an outside hospital.  He was
found to have a small amount of subarachnoid hematoma.
However, his [**Location (un) 2611**] coma score was 15, and he was
transferred here for further evaluation.  He initially was
complaining of left shoulder pain.  There was no evidence of
hypoxia or hypotension on transfer.  Upon arrival to the
Emergency Department here at [**Hospital6 2018**] on the evening of [**2199-3-10**], basic trauma activation
ensued.  He was otherwise well up until the time of this
incident.

PAST MEDICAL HISTORY:  None.

PAST SURGICAL HISTORY:  None.

SOCIAL HISTORY:  Denies alcohol or smoking.  He is single.
He has a significant other, female.  [**Name2 (NI) **] children.

ALLERGIES:  No known drug allergies.

MEDICATIONS:  None.

PHYSICAL EXAM - VITALS ON PRESENTATION:  97.2 rectally, blood
pressure 134/58, heart rate 58, respiratory rate 16, satting
100% on room air.  He was alert and oriented, following
commands, moving all extremities.  He had a full sensory
exam.  His [**Location (un) 2611**] coma score was 15.  His pupils were equal
and reactive, round to light and accommodation.  Extraocular
movements were intact.  His pupils were 5 to 3, brisk
bilaterally.  His TMs were clear.  His oropharynx was
negative.  His midface was stable.  His trachea was midline.
There was no neck crepitus.  His neck was supple.  He had
some mild neck tenderness on the left side approximately 4-5
cm off of the midline.  There was no midline tenderness or
stepoff.  His lungs were clear to auscultation bilaterally.
There was no crepitus.  His chest was without deformity or
tenderness.  He did have an obvious left shoulder deformity
and tenderness.  He had decreased range of motion of the left
upper extremity secondary to pain in his left shoulder.  His
abdomen was soft, nontender, nondistended.  There was road
rash noted across his left chest wall, left back, and left
buttock.  No obvious laceration or bleeding were noted
anywhere.  No other extremities were noted for deformity.
His pelvis was stable.  He had palpable pulses throughout.

He had had a lateral C-spine at the outside hospital which
was otherwise within normal limits.  A CT of the head that
was completed here showed a small right-sided subarachnoid
frontal and parietal lobe hematoma/hemorrhage.  This appeared
to be stable when compared to outside films.  CT of the
C-spine was performed which was otherwise unremarkable.  AP
chest and pelvis were otherwise negative.  He had a FAST
ultrasound in the trauma bay which was, again, also normal.

HOSPITAL COURSE:  The patient was admitted to the Trauma ICU
overnight, placed on q 1 h neuro checks, was loaded with
Dilantin per the neurosurgical service.  At no time during
his hospitalization, or during his prehospitalization was
there any evidence of seizure activity, however.  The
neurosurgeon stated that the patient should have judicious
blood pressure control monitoring, and keeping his BPs less
than 140 ideally in the first 24 hours postinjury.  A
follow-up head CT was ordered for the next morning.  He was
placed on Dilantin after his load as needed.  All fluids were
placed in normal saline.  He was on a q 1 h neuro check
protocol.  He was on C-spine and logroll precautions
overnight.

The following morning, his neuro exam remained completely
intact.  He had been previously seen by orthopedics in the
trauma bay which stated that this was a distal one-third left
clavicular fracture, type 2, which would not require any
operative intervention at this time.  However, Dr. [**Last Name (STitle) 284**]
will need to see the patient in follow-up in approximately 1
week, at which time he will have follow-up x-rays to see how
this fracture is healing.  He will wear a sling for comfort.

By the morning of hospital day #2, the patient was alert and
oriented x 3.  He was afebrile.  Vitals were completely
stable.  His neuro exam was pristine.  A follow-up head CT
showed no evidence of change in his subarachnoid hemorrhage.
Thereafter, his diet was advanced and fluids were Hep-Locked.
He was placed on oral meds.  He was out-of-bed ambulating
with no assistance.  After consultation with the
neurosurgical service and Dr. [**Last Name (STitle) 1132**], it was determined that
the patient was actually stable for discharge to home.

FOLLOW-UP:  He will have no needed follow-up for
neurosurgery, as he will just continue his Dilantin for a
total of 7 days and stop.  He should call the neurosurgical
clinic with Dr. [**Last Name (STitle) 1132**] if at any time he develops any new
weakness, paresthesia, numbness, worsening headache,
incontinence, difficulty with speech, or seizure-like
activity.  He will follow-up with Dr. [**Last Name (STitle) 284**] in
approximately 7 days.  He should call his clinic for an
appointment as an appiontment so that he can have his repeat
shoulder films prior to seeing Dr. [**Last Name (STitle) 284**].  Trauma Clinic
follow-up is only on a PRN basis, as the majority of his care
had been handled by subspecialists.

DISCHARGE DIAGNOSES:
1. Status post biking accident/fall closed head injury with
right frontal and parietal subarachnoid hemorrhage, stable by
repeat CT scan.  No neurologic deficits.
2. Multiple soft tissue abrasions over the left chest, left
flank and left arm.
3. Type 2 left clavicular fracture involving the distal
one-third of this bone.

OUTPATIENT MEDICATIONS:
1. Percocet 5/325, 1-2 tabs po q 4-6 prn.
2. Colace 100 mg po bid to be taken while he is on percocet.
3. Dilantin 100 mg po tid x 7 days and then stop.

If the patient has a primary care provider he should, in
fact, call that primary care provider to have [**Name Initial (PRE) **] follow-up
appointment as an outpatient.  From what I understand, the
patient's PCP is [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **].




                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**], M.D.  [**MD Number(1) 521**]

Dictated By:[**Last Name (NamePattern4) 3204**]
MEDQUIST36

D:  [**2199-3-11**]  14:24
T:  [**2199-3-11**]  16:35
JOB#:  [**Job Number 17531**]

cc:[**Last Name (NamePattern1) 17532**]
{'Subarachnoid hemorrhage following injury without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Pedal cycle accident injuring pedal cyclist,Closed fracture of clavicle, unspecified part,Abrasion or friction burn of trunk, without mention of infection,Abrasion or friction burn of shoulder and upper arm, without mention of infection'}


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 30-year-old male who
fell off his bike while in a race and he was going
approximately 25-30 miles per hour.  There was positive loss
of consciousness at the scene, approximately down for 5
minutes.  He was transferred to an outside hospital.  He was
found to have a small amount of subarachnoid hematoma.
However, his [**Location (un) 2611**] coma score was 15, and he was
transferred here for further evaluation.  He initially was
complaining of left shoulder pain.  There was no evidence of
hypoxia or hypotension on transfer.  Upon arrival to the
Emergency Department here at [**Hospital6 2018**] on the evening of [**2199-3-10**], basic trauma activation
ensued.  He was otherwise well up until the time of this
incident.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Denies alcohol or smoking.  He is single.
He has a significant other, female.  [**Name2 (NI) **] children. 

### Response:
{'Subarachnoid hemorrhage following injury without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Pedal cycle accident injuring pedal cyclist,Closed fracture of clavicle, unspecified part,Abrasion or friction burn of trunk, without mention of infection,Abrasion or friction burn of shoulder and upper arm, without mention of infection'}
