CHIEF COMPLAINT: s/p fall, blunt trauma

PRESENT ILLNESS: Mr. [**Known lastname 87595**] is a 78 yo M with alcoholic cirrhosis who presented
to the ED after an unwitnessed fall in his driveway, during
which he sustained significant head injury. He was intubated in
the field without meds and had a PEA arrest, was successfully
resuscitated with ACLS with return of pulse and pressure and was
brought emergently to the [**Hospital1 18**] ED. GCS 3

MEDICAL HISTORY: PMH: EtOH Cirrhosis, Gout

MEDICATION ON ADMISSION: Citalopram 20', Glipizide 5', levothyroxine 50', lasix 40',
spironolactone 50', tamsulosin 0.4', allopurinol 300'

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: In the ED:
98.4  120  105/55  26 100% on CMV 100% FiO2 500x16 PEEP 5
on both vasopressors and inotropes
in critical condition
unresponsive to voice, negative corneal bilaterally, pupils
fixed and dilated
blood eminating from the left external auditory meatus
RRR, distant heart sounds
coarse breath sounds bilaterally
distended abdomen, improved after NGT decompression
extremities cool

FAMILY HISTORY: nc

SOCIAL HISTORY: + alcohol abuse with resultant liver disease
Subdural 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,Compression of brain,Hemoperitoneum (nontraumatic),Cardiac arrest,Unspecified fall,Alcoholic cirrhosis of liver,Other and unspecified alcohol dependence, unspecified,Gout, unspecified
Subdural hem-deep coma,Compression of brain,Hemoperitoneum,Cardiac arrest,Fall NOS,Alcohol cirrhosis liver,Alcoh dep NEC/NOS-unspec,Gout NOS
Admission Date:  [**2108-10-3**]              Discharge Date:   [**2108-10-4**]

Date of Birth:  [**2030-3-18**]             Sex:   M

Service: SURGERY

Allergies:
No Drug Allergy Information on File

Attending:[**First Name3 (LF) 3200**]
Chief Complaint:
s/p fall, blunt trauma

Major Surgical or Invasive Procedure:
none

History of Present Illness:
Mr. [**Known lastname 87595**] is a 78 yo M with alcoholic cirrhosis who presented
to the ED after an unwitnessed fall in his driveway, during
which he sustained significant head injury. He was intubated in
the field without meds and had a PEA arrest, was successfully
resuscitated with ACLS with return of pulse and pressure and was
brought emergently to the [**Hospital1 18**] ED. GCS 3

Past Medical History:
PMH: EtOH Cirrhosis, Gout

Further history unknown as patient unable to respond.

Social History:
+ alcohol abuse with resultant liver disease

Family History:
nc

Physical Exam:
In the ED:
98.4  120  105/55  26 100% on CMV 100% FiO2 500x16 PEEP 5
on both vasopressors and inotropes
in critical condition
unresponsive to voice, negative corneal bilaterally, pupils
fixed and dilated
blood eminating from the left external auditory meatus
RRR, distant heart sounds
coarse breath sounds bilaterally
distended abdomen, improved after NGT decompression
extremities cool


Pertinent Results:
[**2108-10-3**] 06:24PM   WBC-8.7 RBC-2.24* HGB-6.5* HCT-21.9* MCV-98
MCH-29.2 MCHC-29.9* RDW-19.1*
[**2108-10-3**] 06:35PM   LACTATE-5.0*
[**2108-10-3**] 06:35PM   TYPE-ART PH-7.17*
[**2108-10-3**] 07:25PM   PT-21.2* PTT-70.4* INR(PT)-2.0*
[**2108-10-3**] 07:25PM   ASA-NEG ETHANOL-80* ACETMNPHN-NEG
bnzodzpn-NEG barbitrt-NEG tricyclic-NEG
[**2108-10-3**] 07:25PM   TOT BILI-0.6
[**2108-10-3**] 07:54PM URINE  bnzodzpn-NEG barbitrt-NEG opiates-POS
cocaine-NEG amphetmn-NEG mthdone-NEG

CT head: 1. Large left hyperacute-on-acute hemispheric subdural
hematoma and a smaller right frontal subdural hematoma. 2.
Subarachnoid hemorrhage scattered along the left cerebral
convexity and in the right frontal region. 3. 2.1 cm rightward
shift of midline structures with subfalcine, left uncal,
downward transtentorial and tonsillar herniation. 4. Multiple
skull base fractures as described above involving the sphenoid
[**Doctor First Name 362**], left petrous temporal bone with involvement of the
ossicles and left carotid canal. If there is concern for carotid
artery injury, a CTA can be performed.

CT C-spine: No acute cervical spine fracture is detected. A
rotatory
subluxation of C1 on C2 cannot be excluded based on this study.

CT Torso: 1. Intermesenteric hemorrhage with questionable small
focus of
hyper-attenuation, concerning for possible active extravasation
presumably
from mesenteric vessels. 2. No acute intrathoracic vascular
injury detected. 3. Multiple rib fractures involving the left
posterior first rib, left anterior third to sixth ribs and right
anterior third to seventh ribs. 4. Small sliver of air in the
right pleural space. Possible pneumothorax versus residual air
in the collapsed right lower lobe.  5. Small right effusion with
right lower lobe volume loss and consolidation,
possible aspiration.

Chest Xray: Markedly limited study. For the purposes of the
primary clinical question, the endotracheal tube is in
satisfactory position as above.

Brief Hospital Course:
Mr. [**Known lastname 87595**] was admitted to the Acute Care Surgical service with
a massive traumatic brain injury. He was evaluated by
neurosurgery, who declared his injuries not survivable and no
intervention was offered. A detailed discussion of his
concomitant injuries including rib fractures and possibility of
intrabdominal bleeding were also discussed with family. Given
the unsurvivable head injury, surgical intervention was deemed
futile. He was admitted to the SICU and given supportive care
until the arrival of remaining family members, after which life
support, including vasopressor and ventilatory support, was
removed and the patient passed away shortly thereafter.

Medications on Admission:
Citalopram 20', Glipizide 5', levothyroxine 50', lasix 40',
spironolactone 50', tamsulosin 0.4', allopurinol 300'

Discharge Medications:
NONE - PATIENT EXPIRED

Discharge Disposition:
Expired

Discharge Diagnosis:
unsurvival intracranial hemorrhage and traumatic brain injury

Discharge Condition:
EXPIRED

Discharge Instructions:
N/A - EXPIRED

Followup Instructions:
N/A - EXPIRED
{'Subdural 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,Compression of brain,Hemoperitoneum (nontraumatic),Cardiac arrest,Unspecified fall,Alcoholic cirrhosis of liver,Other and unspecified alcohol dependence, unspecified,Gout, 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: s/p fall, blunt trauma

PRESENT ILLNESS: Mr. [**Known lastname 87595**] is a 78 yo M with alcoholic cirrhosis who presented
to the ED after an unwitnessed fall in his driveway, during
which he sustained significant head injury. He was intubated in
the field without meds and had a PEA arrest, was successfully
resuscitated with ACLS with return of pulse and pressure and was
brought emergently to the [**Hospital1 18**] ED. GCS 3

MEDICAL HISTORY: PMH: EtOH Cirrhosis, Gout

MEDICATION ON ADMISSION: Citalopram 20', Glipizide 5', levothyroxine 50', lasix 40',
spironolactone 50', tamsulosin 0.4', allopurinol 300'

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: In the ED:
98.4  120  105/55  26 100% on CMV 100% FiO2 500x16 PEEP 5
on both vasopressors and inotropes
in critical condition
unresponsive to voice, negative corneal bilaterally, pupils
fixed and dilated
blood eminating from the left external auditory meatus
RRR, distant heart sounds
coarse breath sounds bilaterally
distended abdomen, improved after NGT decompression
extremities cool

FAMILY HISTORY: nc

SOCIAL HISTORY: + alcohol abuse with resultant liver disease 

### Response:
{'Subdural 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,Compression of brain,Hemoperitoneum (nontraumatic),Cardiac arrest,Unspecified fall,Alcoholic cirrhosis of liver,Other and unspecified alcohol dependence, unspecified,Gout, unspecified'}
