CHIEF COMPLAINT: Jetski accident.

PRESENT ILLNESS: The patient is a 17-y.o. male who was involved in a jetski
accident and sustained left femur fracture.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: None.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Non-contributory.

SOCIAL HISTORY: Non-contributory.
Closed fracture of shaft of femur,Closed fracture of pubis,Nontraumatic compartment syndrome of lower extremity,Iatrogenic pneumothorax,Hematoma complicating a procedure,Traumatic shock,Fracture of lateral malleolus, closed,Accident to watercraft causing other injury to occupant of small boat, powered,Surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation,Contusion of lung without mention of open wound into thorax,Open wound of forehead, without mention of complication,Hypopotassemia,Disorders of phosphorus metabolism,Iron deficiency anemia secondary to blood loss (chronic),Thrombocytopenia, unspecified
Fx femur shaft-closed,Fracture of pubis-closed,Nontraum comp syn-low ex,Iatrogenic pneumothorax,Hematoma complic proc,Traumatic shock,Fx lateral malleolus-cl,Boat acc inj NEC-power,Abn react-artif implant,Lung contusion-closed,Open wound of forehead,Hypopotassemia,Dis phosphorus metabol,Chr blood loss anemia,Thrombocytopenia NOS
Admission Date:  [**2112-5-19**]              Discharge Date:   [**2112-5-26**]

Date of Birth:  [**2094-4-24**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 4691**]
Chief Complaint:
Jetski accident.

Major Surgical or Invasive Procedure:
[**5-20**]: s/p Left femoral nail placement
[**5-20**]: left femur and tibia compartment release and vac placement
[**5-23**]: I&D and wound closure


History of Present Illness:
The patient is a 17-y.o. male who was involved in a jetski
accident and sustained left femur fracture.

Past Medical History:
None.

Social History:
Non-contributory.

Family History:
Non-contributory.

Pertinent Results:
[**2112-5-19**] 07:45PM   FIBRINOGE-186
[**2112-5-19**] 07:45PM   PT-15.0* PTT-25.9 INR(PT)-1.3*
[**2112-5-19**] 07:45PM   PLT COUNT-391
[**2112-5-19**] 07:45PM   WBC-27.0* RBC-4.40* HGB-13.4* HCT-39.1*
MCV-89 MCH-30.5 MCHC-34.3 RDW-12.7
[**2112-5-19**] 07:45PM   ASA-NEG ETHANOL-NEG ACETMNPHN-NEG
bnzodzpn-NEG barbitrt-NEG tricyclic-NEG
[**2112-5-19**] 07:45PM   LIPASE-42
[**2112-5-19**] 07:45PM   UREA N-15 CREAT-1.2
[**2112-5-19**] 08:03PM   freeCa-1.08*
[**2112-5-19**] 08:03PM   HGB-13.9* calcHCT-42 O2 SAT-75 CARBOXYHB-2
MET HGB-0
[**2112-5-19**] 08:03PM   GLUCOSE-178* LACTATE-2.0 NA+-140 K+-3.7
CL--101 TCO2-25
[**2112-5-19**] 11:08PM   LACTATE-1.7

[**2112-5-19**]: CXR showed clear lungs.
[**2112-5-19**]: CT head showed no abnormalities.
[**2112-5-19**]: CT chest showed lung contusion.
[**2112-5-19**]: CT abdomen showed no abnormalities.
[**2112-5-19**]: CT pelvis showed contusion and edema of the left
obturator internus and vasti muscles.
[**2112-5-19**]: CT C-spine showed no fracture.
[**2112-5-19**]: XR femur/tib/fib showed comminuted displaced fracture
through the upper femoral diaphysis with mild varus angulation.

Brief Hospital Course:
On [**2112-5-20**], the patient underwent fixation of the femur by
intramedullary nail. Shortly post-op, while in the PACU, he
experienced a significant increase in pain and swelling in the
left femur and was returned to the OR for four-compartment
fasciotomy. A large hematoma was evacuated from underneath the
vastus and the muscles remained viable. The compartments felt
softer, though still with some swelling, and the wound was
closed with assistance from two VAC sponges. During this time,
he also developed a pneumothorax, confirmed on CXR, and a chest
tube was placed. Post-op, he was admitted to the TSICU. On
[**2112-5-23**], orthopedics took the patient back to the OR for I&D of
left thigh and leg and closure, after which he was admitted to
the floor. On [**2112-5-24**], the pneumothorax resolved and the chest
tube was removed. On [**2112-5-26**], the patient was discharged home
after consultation with PT.

Medications on Admission:
None.

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day): Continue while on narcotics.
2. Oxycodone 20 mg Tablet Sustained Release 12 hr Sig: One (1)
Tablet Sustained Release 12 hr PO Q12H (every 12 hours).
Disp:*60 Tablet Sustained Release 12 hr(s)* Refills:*0*
3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for breakthrough pain.
Disp:*60 Tablet(s)* Refills:*0*
4. Milk of Magnesia 800 mg/5 mL Suspension Sig: Thirty (30) ML's
PO twice a day.
5. Enoxaparin 40 mg/0.4 mL Syringe Sig: Forty (40) MG
Subcutaneous DAILY (Daily) for 4 weeks.
Disp:*30 MG* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
s/p jetski crash
Left femur fracture
Non-displaced left fibular fracture
Compartment syndrome of left lower extremity


Discharge Condition:
Hemodynamically stable, tolerating a regular diet, pain
adequately controlled.


Discharge Instructions:
You may bear weight as toelrated on your left leg.

It is important that you walk several times during the day to
help with circulation and to minimize risks of developing blood
clots.

You have been prescribed Lovenox injections by Orthopedics; this
is a blood thinner to help prevent blood clots.

Return to the Emergency room if you develop any fevers, chills,
shortness of breath, increased pain, swelling in your calf,
nausea, vomitng, diarrhea and/or any other symptoms that are
concerning to you.

Followup Instructions:
Follow-up in Orthopaedic Trauma Clinic with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **],
NP in 2 weeks.  Call [**Telephone/Fax (1) 1228**] to schedule an appointment.



Completed by:[**2112-5-27**]
{'Closed fracture of shaft of femur,Closed fracture of pubis,Nontraumatic compartment syndrome of lower extremity,Iatrogenic pneumothorax,Hematoma complicating a procedure,Traumatic shock,Fracture of lateral malleolus, closed,Accident to watercraft causing other injury to occupant of small boat, powered,Surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation,Contusion of lung without mention of open wound into thorax,Open wound of forehead, without mention of complication,Hypopotassemia,Disorders of phosphorus metabolism,Iron deficiency anemia secondary to blood loss (chronic),Thrombocytopenia, unspecified'}


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: Jetski accident.

PRESENT ILLNESS: The patient is a 17-y.o. male who was involved in a jetski
accident and sustained left femur fracture.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: None.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Non-contributory.

SOCIAL HISTORY: Non-contributory. 

### Response:
{'Closed fracture of shaft of femur,Closed fracture of pubis,Nontraumatic compartment syndrome of lower extremity,Iatrogenic pneumothorax,Hematoma complicating a procedure,Traumatic shock,Fracture of lateral malleolus, closed,Accident to watercraft causing other injury to occupant of small boat, powered,Surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation,Contusion of lung without mention of open wound into thorax,Open wound of forehead, without mention of complication,Hypopotassemia,Disorders of phosphorus metabolism,Iron deficiency anemia secondary to blood loss (chronic),Thrombocytopenia, unspecified'}
