CHIEF COMPLAINT: 

PRESENT ILLNESS: Mr. [**Name13 (STitle) 23195**] is a 40-year-old
man, who was brought to the emergency room after he was found
by the EMS with stab wound to his left lateral lower chest.
He was alert and oriented at the scene, however, agitated on
arrival and he had stridor on arrival.  He was admitted to
the ICU after intubation in the trauma bay.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: None.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: After the patient was extubated and
communicative, it is apparent that he is homeless and lives
on the streets.
Traumatic pneumothorax with open wound into thorax,Assault by cutting and piercing instrument,Alcohol abuse, unspecified,Lack of housing
Traum pneumothorax-open,Assault-cutting instr,Alcohol abuse-unspec,Lack of housing
Admission Date:  [**2139-2-13**]       Discharge Date:  [**2139-2-20**]

Date of Birth:                    Sex:  M

Service:  TRAUMA

HISTORY OF THE PRESENT ILLNESS:  Mr. [**Name13 (STitle) 23195**] is a 40-year-old
man, who was brought to the emergency room after he was found
by the EMS with stab wound to his left lateral lower chest.
He was alert and oriented at the scene, however, agitated on
arrival and he had stridor on arrival.  He was admitted to
the ICU after intubation in the trauma bay.

PAST MEDICAL HISTORY:  None.

PAST SURGICAL HISTORY:  None.

MEDICATIONS ON ADMISSION:  None.

ALLERGIES:  The patient has no known drug allergies.

SOCIAL HISTORY:  After the patient was extubated and
communicative, it is apparent that he is homeless and lives
on the streets.

PHYSICAL EXAMINATION:  Examination revealed the following:
VITAL SIGNS:  Pulse 84, blood pressure 150/palpation,
respirations 12 saturating, 82% on arrival.  The patient is
combative, but moves all four extremities.  HEENT:  Equal and
reactive pupils.  GCS:  7.  Neck was supple.  There were no
stepoffs.  He has crepitus over the left chest wall and he
has a stab wound approximately 3-cm wide in the left
mid-axillary wall below the nipple line.  ABDOMEN:  Soft,
without guarding and mildly distended.  EXTREMITIES:  No
obvious deformities.  He has palpable pulses distally.
RECTAL:  Examination is guaiac negative with normal tone.

LABORATORY DATA:  Labs studies revealed the following:  White
count 12.7, hematocrit 47, platelet count 275,000.
Electrolytes:  sodium 142, potassium 4.4, chloride 97,
bicarbonate 31, BUN 10, creatinine 0.9, glucose 117, PT 11.7,
PTT 27, INR 1.0, amylase 68, toxicology screen positive for
opiates, fibrinogen 229, lactate 2.7.

RADIOLOGICAL STUDIES:  CT of the head showed no evidence of
intracranial hemorrhage.  CT of the chest upon arrival showed
no injury to the great vessels or the pericardium.  There is
a left lateral lower chest-wall hematoma.  There was a small
pneumothorax, anteromedial portion of the left chest.  There
was some subcutaneous emphysema of the left chest.  CT of the
abdomen, upon arrival, showed no injury to the solid organs.
CT of the abdomen, PO and IV contrast, repeated on hospital
day #2, shows no evidence of injury to the solid organs or
viscera.  There is no peritoneal free air.  Cervical spine
films with three views show normal cervical spine with some
degenerative joint disease.  TLS films are negative for
fracture.

CONCISE SUMMARY OF HOSPITAL COURSE:  Mr. [**Name13 (STitle) 23195**] was admitted
after acute trauma of the left chest stab wound below the
nipple line on the lateral chest.  He was admitted to the ICU
for ventilatory support and left hemothorax management.
Hospital course is described below by systems.

#1.  NEUROLOGICAL:  Mr. [**Name13 (STitle) 23195**] presented with positive
alcohol level and he was initially for a few days.  He
required adjuvant support to prevent any withdrawal.  He was
eventually extubated without problems.  At times, he has been
agitated, however, over the progression of his hospital
course, he is now alert and oriented times three.  He is
appropriate at this level.

He is currently taking Percocet for pain, however, this can
be weaned off as tolerated.

#2.  CARDIOVASCULAR:  CT scan of the chest shows no injury to
his mediastinal vessels.  Over the hospital course,
Mr.  [**Name13 (STitle) 23195**] has remained hemodynamically stable.  He is on no
cardiac medications.

#3.  RESPIRATORY:  Mr. [**Name13 (STitle) 23195**] suffered a wound to his left
chest giving him a left hemothorax, which needed evacuation
with a left chest tube.  This chest tube was weaned over his
hospital course and followed up with chest x-ray.

On discharge, he has some rhonchi on the left side, however,
he is able to be comfortable and ambulate on the floor on
room air.  He has two wounds on his left chest; one is
original stab wound and one is the chest-tube incision site.
Both were draining serosanguinous material, which are being
treated with dry dressings as needed.  He is expected to
resolve this drainage and heal these wounds secondarily
without any intervention.  He will require aggressive
pulmonary toilet with incentive spirometry to facilitate his
pulmonary recovery.

#4.  GASTROINTESTINAL:  Mr. [**Last Name (Titles) 23195**], after being extubated,
has been progressed to a regular diet, which he is tolerating
without problems.  [**Name (NI) **] received CT scan of the abdomen with PO
and IV contrast, which showed no apparent injury to solid
organs or his bowel.  He is now well over the time to have a
visceral injury and his examination is benign with a soft
abdomen.  He is to continue a regular diet.  He is being
taken off H2 blockers since he is already on a regular diet.

#5:  INFECTIOUS DISEASE:  Mr. [**Name13 (STitle) 23195**] has no evidence of any
infection and he is not on any antibiotics.

#6.  HEMATOLOGY:  Mr. [**Name13 (STitle) 23195**] had normal coagulation studies
on admission and he has had stable hematocrit at 30 over the
last few days.

#7.  PROPHYLAXIS:  Mr. [**Name13 (STitle) 23195**] has been on heparin
subcutaneously prophylaxis during his admission.  However,
now that he is ambulating well, this can be discontinued if
he continues to ambulate well.

#8.  ALCOHOL USE:  Mr. [**Name13 (STitle) 23195**] was given initially some Ativan
as prophylaxis to treat any history of alcohol use.  He is
off this now and he will need counseling to keep him away
from any substance abuse.  He was given a nicotine patch to
suppress his urge for smoking.

#9.  RENAL:  Mr. [**Name13 (STitle) 23195**] is able to void spontaneously and he
has had adequate urine output throughout his admission.

#10.  WOUND CARE:  Wound care is as described under the
respiratory section.  He will need dry dressings p.r.n. until
the drainage stops.

SUMMARY:  In summary, Mr. [**Name13 (STitle) 23195**] was brought to [**Hospital1 346**] with chest wound, post stabbing.  He
has required initial intubation and ventilatory support.
However, he was easily extubated after his wound was found to
not have caused any injury to his major vessels or abdominal
viscera.  He has an injury to his lung, which caused
hemothorax, which has now resolved and he currently has two
small wounds on his chest, secondary to his stabbing and his
chest tube.  These wounds required local care.

On discharge, he is able to ambulate, tolerate regular diet.
He is voiding spontaneously and he is having bowel movements.
He is on Percocet for pain.  He will followup with the trauma
clinic in two weeks for routine followup.

FOLLOW-UP CARE:  The patient will followup in the trauma
clinic in two weeks.  Phone #:  [**Telephone/Fax (1) 274**].

DISCHARGE MEDICATIONS:
1.  Nicotine patch 21 mg q.d.
2.  Heparin 5000 units subcutaneously b.i.d. discontinue when
ambulating well.
3.  Percocet 5, one to two p.o.q.4h. to 6h.p.r.n., wean as
tolerated.
4.  Tylenol 650 mg p.o.q.6h.p.r.n.
5.  Multivitamin, one p.o.q.d.

DISCHARGE DIAGNOSES:  Left chest stabbing with left
hemothorax.




                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2213**], M.D.  [**MD Number(1) 2214**]

Dictated By:[**Name8 (MD) 180**]
MEDQUIST36

D:  [**2139-2-20**]  11:41
T:  [**2139-2-20**]  11:56
JOB#:  [**Job Number 38724**]
[**2139-2-20**]


Admission Date:  [**2139-2-13**]       Discharge Date:  [**2139-2-20**]

Date of Birth:                    Sex:  M

Service:  TRAUMA

HISTORY OF THE PRESENT ILLNESS:  Mr. [**Name13 (STitle) 23195**] is a 40-year-old
man, who was brought to the emergency room after he was found
by the EMS with stab wound to his left lateral lower chest.
He was alert and oriented at the scene, however, agitated on
arrival and he had stridor on arrival.  He was admitted to
the ICU after intubation in the trauma bay.

PAST MEDICAL HISTORY:  None.

PAST SURGICAL HISTORY:  None.

MEDICATIONS ON ADMISSION:  None.

ALLERGIES:  The patient has no known drug allergies.

SOCIAL HISTORY:  After the patient was extubated and
communicative, it is apparent that he is homeless and lives
on the streets.

PHYSICAL EXAMINATION:  Examination revealed the following:
VITAL SIGNS:  Pulse 84, blood pressure 150/palpation,
respirations 12 saturating, 82% on arrival.  The patient is
combative, but moves all four extremities.  HEENT:  Equal and
reactive pupils.  GCS:  7.  Neck was supple.  There were no
stepoffs.  He has crepitus over the left chest wall and he
has a stab wound approximately 3-cm wide in the left
mid-axillary wall below the nipple line.  ABDOMEN:  Soft,
without guarding and mildly distended.  EXTREMITIES:  No
obvious deformities.  He has palpable pulses distally.
RECTAL:  Examination is guaiac negative with normal tone.

LABORATORY DATA:  Labs studies revealed the following:  White
count 12.7, hematocrit 47, platelet count 275,000.
Electrolytes:  sodium 142, potassium 4.4, chloride 97,
bicarbonate 31, BUN 10, creatinine 0.9, glucose 117, PT 11.7,
PTT 27, INR 1.0, amylase 68, toxicology screen positive for
opiates, fibrinogen 229, lactate 2.7.

RADIOLOGICAL STUDIES:  CT of the head showed no evidence of
intracranial hemorrhage.  CT of the chest upon arrival showed
no injury to the great vessels or the pericardium.  There is
a left lateral lower chest-wall hematoma.  There was a small
pneumothorax, anteromedial portion of the left chest.  There
was some subcutaneous emphysema of the left chest.  CT of the
abdomen, upon arrival, showed no injury to the solid organs.
CT of the abdomen, PO and IV contrast, repeated on hospital
day #2, shows no evidence of injury to the solid organs or
viscera.  There is no peritoneal free air.  Cervical spine
films with three views show normal cervical spine with some
degenerative joint disease.  TLS films are negative for
fracture.

CONCISE SUMMARY OF HOSPITAL COURSE:  Mr. [**Name13 (STitle) 23195**] was admitted
after acute trauma of the left chest stab wound below the
nipple line on the lateral chest.  He was admitted to the ICU
for ventilatory support and left hemothorax management.
Hospital course is described below by systems.

#1.  NEUROLOGICAL:  Mr. [**Name13 (STitle) 23195**] presented with positive
alcohol level and he was initially for a few days.  He
required adjuvant support to prevent any withdrawal.  He was
eventually extubated without problems.  At times, he has been
agitated, however, over the progression of his hospital
course, he is now alert and oriented times three.  He is
appropriate at this level.

He is currently taking Percocet for pain, however, this can
be weaned off as tolerated.

#2.  CARDIOVASCULAR:  CT scan of the chest shows no injury to
his mediastinal vessels.  Over the hospital course,
Mr.  [**Name13 (STitle) 23195**] has remained hemodynamically stable.  He is on no
cardiac medications.

#3.  RESPIRATORY:  Mr. [**Name13 (STitle) 23195**] suffered a wound to his left
chest giving him a left hemothorax, which needed evacuation
with a left chest tube.  This chest tube was weaned over his
hospital course and followed up with chest x-ray.

On discharge, he has some rhonchi on the left side, however,
he is able to be comfortable and ambulate on the floor on
room air.  He has two wounds on his left chest; one is
original stab wound and one is the chest-tube incision site.
Both were draining serosanguinous material, which are being
treated with dry dressings as needed.  He is expected to
resolve this drainage and heal these wounds secondarily
without any intervention.  He will require aggressive
pulmonary toilet with incentive spirometry to facilitate his
pulmonary recovery.

#4.  GASTROINTESTINAL:  Mr. [**Last Name (Titles) 23195**], after being extubated,
has been progressed to a regular diet, which he is tolerating
without problems.  [**Name (NI) **] received CT scan of the abdomen with PO
and IV contrast, which showed no apparent injury to solid
organs or his bowel.  He is now well over the time to have a
visceral injury and his examination is benign with a soft
abdomen.  He is to continue a regular diet.  He is being
taken off H2 blockers since he is already on a regular diet.

#5:  INFECTIOUS DISEASE:  Mr. [**Name13 (STitle) 23195**] has no evidence of any
infection and he is not on any antibiotics.

#6.  HEMATOLOGY:  Mr. [**Name13 (STitle) 23195**] had normal coagulation studies
on admission and he has had stable hematocrit at 30 over the
last few days.

#7.  PROPHYLAXIS:  Mr. [**Name13 (STitle) 23195**] has been on heparin
subcutaneously prophylaxis during his admission.  However,
now that he is ambulating well, this can be discontinued if
he continues to ambulate well.

#8.  ALCOHOL USE:  Mr. [**Name13 (STitle) 23195**] was given initially some Ativan
as prophylaxis to treat any history of alcohol use.  He is
off this now and he will need counseling to keep him away
from any substance abuse.  He was given a nicotine patch to
suppress his urge for smoking.

#9.  RENAL:  Mr. [**Name13 (STitle) 23195**] is able to void spontaneously and he
has had adequate urine output throughout his admission.

#10.  WOUND CARE:  Wound care is as described under the
respiratory section.  He will need dry dressings p.r.n. until
the drainage stops.

SUMMARY:  In summary, Mr. [**Name13 (STitle) 23195**] was brought to [**Hospital1 346**] with chest wound, post stabbing.  He
has required initial intubation and ventilatory support.
However, he was easily extubated after his wound was found to
not have caused any injury to his major vessels or abdominal
viscera.  He has an injury to his lung, which caused
hemothorax, which has now resolved and he currently has two
small wounds on his chest, secondary to his stabbing and his
chest tube.  These wounds required local care.

On discharge, he is able to ambulate, tolerate regular diet.
He is voiding spontaneously and he is having bowel movements.
He is on Percocet for pain.  He will followup with the trauma
clinic in two weeks for routine followup.

FOLLOW-UP CARE:  The patient will followup in the trauma
clinic in two weeks.  Phone #:  [**Telephone/Fax (1) 274**].

DISCHARGE MEDICATIONS:
1.  Nicotine patch 21 mg q.d.
2.  Heparin 5000 units subcutaneously b.i.d. discontinue when
ambulating well.
3.  Percocet 5, one to two p.o.q.4h. to 6h.p.r.n., wean as
tolerated.
4.  Tylenol 650 mg p.o.q.6h.p.r.n.
5.  Multivitamin, one p.o.q.d.

DISCHARGE DIAGNOSES:  Left chest stabbing with left
hemothorax.




                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2213**], M.D.  [**MD Number(1) 2214**]

Dictated By:[**Name8 (MD) 180**]
MEDQUIST36

D:  [**2139-2-20**]  11:41
T:  [**2139-2-20**]  11:56
JOB#:  [**Job Number 38724**]
{'Traumatic pneumothorax with open wound into thorax,Assault by cutting and piercing instrument,Alcohol abuse, unspecified,Lack of housing'}


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: Mr. [**Name13 (STitle) 23195**] is a 40-year-old
man, who was brought to the emergency room after he was found
by the EMS with stab wound to his left lateral lower chest.
He was alert and oriented at the scene, however, agitated on
arrival and he had stridor on arrival.  He was admitted to
the ICU after intubation in the trauma bay.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: None.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: After the patient was extubated and
communicative, it is apparent that he is homeless and lives
on the streets. 

### Response:
{'Traumatic pneumothorax with open wound into thorax,Assault by cutting and piercing instrument,Alcohol abuse, unspecified,Lack of housing'}
