CHIEF COMPLAINT: Fall

PRESENT ILLNESS: Pt fell 6 stories hitting several objects on way down, and was
found laying prone on concrete surface with respirations.

MEDICAL HISTORY: Unknown

MEDICATION ON ADMISSION: unknown

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Pt passed in the OR

FAMILY HISTORY: unknown

SOCIAL HISTORY: unknown
Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, 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,Injury to liver without mention of open wound into cavity laceration, unspecified,Injury to spleen without mention of open wound into cavity, unspecified injury,Closed fracture of malar and maxillary bones,Accidental fall from or out of building or other structure,Contusion of lung without mention of open wound into thorax
Cl skl base fx-deep coma,Traum pneumothorax-close,Liver lacerat unspcf cls,Spleen injury NOS-closed,Fx malar/maxillary-close,Fall from building,Lung contusion-closed
Admission Date:  [**2185-9-4**]              Discharge Date:   [**2185-9-4**]

Date of Birth:  [**2159-1-11**]             Sex:   M

Service: SURGERY

Allergies:
No Drug Allergy Information on File

Attending:[**First Name3 (LF) 371**]
Chief Complaint:
Fall

Major Surgical or Invasive Procedure:
Exploratory laparotomy, thoracotomy

History of Present Illness:
Pt fell 6 stories hitting several objects on way down, and was
found laying prone on concrete surface with respirations.

Past Medical History:
Unknown

Social History:
unknown

Family History:
unknown

Physical Exam:
Pt passed in the OR

Pertinent Results:
Head CT
1. Findings consistent with diffuse cerebral edema with
effacement of the
suprasellar cistern concerning for uncal herniation. Subfalcine
herniation
approximately 6 mm to the left.
2. Right subdural hematoma.
3. Fractures of the anterior and posterior walls of the right
maxillary sinus as well as minimally displaced fracture of the
right frontal bone. Extensive hemorrhage in the paranasal
sinuses as well as extensive hematoma formation and subcutaneous
emphysema of the face, right greater than left. CT of the facial
bones is suggested for further evaluation.

CT torso
1. Moderate-to-large sized anterior mediastinal hematoma with
hyperdensity
underlying the sternum concerning for active arterial bleeding.
The source is not clearly defined but is more likely from the
thoracic cage, such as an intercostal artery. The great vessels
including aorta appear to be intact without evidence of
transsection or dissection.
2. Moderate left pneumothorax and small right pneumothorax.
3. Extensive pulmonary parenchymal contusion.
4. Large laceration of the hepatic dome with evidence of active
arterial
bleeding.
5. Splenic laceration.
6. Moderate amount of free blood in the low pelvis.

CT C-spine
No fracture or malalignment of the cervical spine

CT facial:
There are comminuted fractures through the anterior, posterior,
inferior and medial walls of the right maxillary sinus. There
are comminuted fractures of the medial and lateral right
pterygoid plates. There is a mildly displaced fracture of the
left zygomatic arch. There is a nondisplaced fracture of the
right frontal bone which extends into the right temporal bone.
There are comminuted fractures of the nasal bone and medial wall
of the left orbit. There is extensive hemorrhage throughout the
paranasal sinuses. There is significant soft tissue swelling and
subcutaneous emphysema of the face and forehead, right greater
than left. The globes appear intact.


Brief Hospital Course:
Pt fell 6 stories hitting several objects on way down, and was
found laying prone on concrete surface with respirations. He as
transported to [**Hospital1 **] via ambulence, and arrived intubated.

In trauma bay placement of ET tube was verified. Pt had O2 sats
in the 80's which came up to the 90's with bilater needle
decompressions, and bilateral chest tubes were placed.  Central
access was obtained, and pt began recieving resussitative blood
products and fluid.  Fast was initially read as positive, but
later debated.

After emergent CT, pt was taken to the OR for ex-lap,
thoracotomy, and bolt placement.  Pt died in OR due to decreased
oxygenation, hemorrhage, and hypotension.

Medications on Admission:
unknown

Discharge Medications:
none

Discharge Disposition:
Expired

Discharge Diagnosis:
dead

Discharge Condition:
dead

Discharge Instructions:
none

Followup Instructions:
none
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, 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,Injury to liver without mention of open wound into cavity laceration, unspecified,Injury to spleen without mention of open wound into cavity, unspecified injury,Closed fracture of malar and maxillary bones,Accidental fall from or out of building or other structure,Contusion of lung without mention of open wound into thorax'}


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: Fall

PRESENT ILLNESS: Pt fell 6 stories hitting several objects on way down, and was
found laying prone on concrete surface with respirations.

MEDICAL HISTORY: Unknown

MEDICATION ON ADMISSION: unknown

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Pt passed in the OR

FAMILY HISTORY: unknown

SOCIAL HISTORY: unknown 

### Response:
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, 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,Injury to liver without mention of open wound into cavity laceration, unspecified,Injury to spleen without mention of open wound into cavity, unspecified injury,Closed fracture of malar and maxillary bones,Accidental fall from or out of building or other structure,Contusion of lung without mention of open wound into thorax'}
