CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 39-year-old
gentleman unrestrained driver of a car that hit a wall with
significant damage to the car and no loss of consciousness.
The patient was hemodynamically stable, taken to [**Hospital 48386**]
Hospital, where multiple x-rays demonstrated pelvic and foot
fractures, which is transferred to [**Hospital3 **] for further
treatment.

MEDICAL HISTORY: 1. Psychotic disorder with history of multiple psychiatric
admissions.
2. History of three previous severe motor vehicle collisions.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Two pack per day smoker, lives alone.
Closed fracture of vault of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Closed fracture of acetabulum,Schizoaffective disorder, unspecified,Acute posthemorrhagic anemia,Retention of urine, unspecified,Pneumonia, organism unspecified,Other motor vehicle nontraffic accident involving collision with stationary object injuring driver of motor vehicle other than motorcycle,Traumatic pneumohemothorax without mention of open wound into thorax
Cl skull vlt fx-brf coma,Lung contusion-closed,Fracture acetabulum-clos,Schizoaffective dis NOS,Ac posthemorrhag anemia,Retention urine NOS,Pneumonia, organism NOS,Oth coll stndng obj-driv,Traum pneumohemothor-cl
Admission Date:  [**2172-4-20**]       Discharge Date:  [**2172-4-28**]

Date of Birth:   [**2132-8-14**]       Sex:  M

Service:  Trauma

HISTORY OF PRESENT ILLNESS:  The patient is a 39-year-old
gentleman unrestrained driver of a car that hit a wall with
significant damage to the car and no loss of consciousness.
The patient was hemodynamically stable, taken to [**Hospital 48386**]
Hospital, where multiple x-rays demonstrated pelvic and foot
fractures, which is transferred to [**Hospital3 **] for further
treatment.

PAST MEDICAL HISTORY:
1. Psychotic disorder with history of multiple psychiatric
admissions.
2. History of three previous severe motor vehicle collisions.

PAST SURGICAL HISTORY:
1. Laparotomy from previous motor vehicle collision.
2. Left hip fracture that was fixed surgically.
3. Multiple long bone fractures also fixed surgically.

MEDICATIONS:
1. Depakote.
2. Haldol.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  Two pack per day smoker, lives alone.

PHYSICAL EXAMINATION:  Initial vital signs:  Temperature of
98.4, blood pressure 130/80, respiratory rate 16, and sating
99%, heart rate 99.  Patient had a right cheek laceration
around 4 cm.  Pupils are equal, round, and reactive to light.
There is periorbital ecchymoses.  Tympanic membranes are
clear.  Lungs are clear to auscultation bilaterally.   Heart
regular, rate, and rhythm.  Abdomen is soft, nontender,
nondistended.  Pelvic:  Tenderness to palpation.  There is a
4 cm laceration over the right knee with exposure of the
joint.

INITIAL LABORATORIES:  Hematocrit of 39 and urine screen was
positive for cocaine and opiates, and serum tox is negative.

Chest x-ray showed no widen mediastinum and no fracture.
Pelvis x-ray showed a left acetabular fracture.

CT scan of the head shows subarachnoid hemorrhage of the left
and right frontal.  Abdominal CT scan showed minimal amount
of fluid around the liver.  Chest CT scan showed large right
middle lobe collection and air fluid level in the right lower
lobe.  Pelvic CT scan showed right acetabular fractures that
is intraarticular, and left rami fracture.  CT scan of the
spine was negative.  Knee films show a right patellar
fracture.  X-rays of the left hand showed multiple metacarpal
injuries, fractures.  Right foot film showed metatarsal
fractures, multiple.

Orthopedics was consulted, and patient went to the operating
room for washout of the right knee and repair of the patella.
The acetabular fractures were not fixed per Orthopedics.  The
patient remains nonweightbearing on the right and touchdown
weightbearing on the left, and weightbearing as tolerated on
the left.

Per Neurosurgery, repeat CT scan of the head was obtained.
Showed improvement in the bleed.  Therefore, no operative
management was required.  Psychiatry consult was obtained as
well.  A sitter was recommended given the patient's possible
suicidal tendency.  The patient was told to continue his
depakote.  He is diagnosed with schizo-affective disorder by
history, cocaine dependence, and resolving delirium.

The patient was transferred to the floor on [**2172-4-25**].
Patient also had a bronchoalveolar lavage to better assess
the fluid collection as well as workup of elevated
temperature.  They all grew gram-negative rods and a fungi,
thus not [**Female First Name (un) 564**] albicans.  Patient was started on Levaquin
for duration of [**6-18**] days as well as fluconazole for 7-10
days.

The patient was stable on the floor, hemodynamically stable,
and patient is tolerating po and sitter was discontinued.
The patient also had a Physical Therapy consult, which
recommended physical therapy 3x a week.  Given the patient's
weightbearing status, the patient will be transferred to
rehabilitation facility for further evaluation and further
management.

DISCHARGE MEDICATIONS:
1. Lovenox 30 mg subQ [**Hospital1 **] x1 week, then 60 mg subQ [**Hospital1 **].
2. Levaquin 500 mg po q day until [**5-3**].
3. Fluconazole 200 mg po q day until [**5-3**].
4. Percocet 1-2 tablets po q4-6h for pain.
5. Albuterol.
6. Colace.
7. Depakote 1,000 mg po bid starting on the 20th and prior to
that, 750 mg.

CONDITION ON DISCHARGE:  Good.



                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 18153**], M.D.  [**MD Number(1) 18154**]

Dictated By:[**Last Name (NamePattern1) 19796**]
MEDQUIST36

D:  [**2172-4-27**]  12:59
T:  [**2172-4-27**]  13:11
JOB#:  [**Job Number 48387**]


Admission Date:  [**2172-4-20**]       Discharge Date:  [**2172-5-1**]

Date of Birth:   [**2132-8-14**]       Sex:  M

Service:  Trauma

ADDENDUM:  This is an Addendum to the previous dictation.

The patient is a 39-year-old gentleman, status post motor
vehicle crash, transferred from an outside hospital with
multiple pelvic fractures.

During the remainder of his hospital course, while awaiting
rehabilitation, had Foley discontinued and was not able to
void for 12 hours.  Upon replacement of the Foley 1200 cc of
urine came out.  The Foley was left in place for a day and a
half.  After removing the Foley the patient was able to
urinate after four hours.

DISCHARGE DISPOSITION:  In consultation with Case Management,
a bed was available at a rehabilitation facility and the
patient was to be discharged to a rehabilitation facility.

CONDITION AT DISCHARGE:  Condition on discharge was good.




                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 18153**], M.D.  [**MD Number(1) 18154**]

Dictated By:[**Name8 (MD) 48388**]
MEDQUIST36

D:  [**2172-4-30**]  15:22
T:  [**2172-4-30**]  15:44
JOB#:  [**Job Number 48389**]
{'Closed fracture of vault of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Closed fracture of acetabulum,Schizoaffective disorder, unspecified,Acute posthemorrhagic anemia,Retention of urine, unspecified,Pneumonia, organism unspecified,Other motor vehicle nontraffic accident involving collision with stationary object injuring driver of motor vehicle other than motorcycle,Traumatic pneumohemothorax 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: 

PRESENT ILLNESS: The patient is a 39-year-old
gentleman unrestrained driver of a car that hit a wall with
significant damage to the car and no loss of consciousness.
The patient was hemodynamically stable, taken to [**Hospital 48386**]
Hospital, where multiple x-rays demonstrated pelvic and foot
fractures, which is transferred to [**Hospital3 **] for further
treatment.

MEDICAL HISTORY: 1. Psychotic disorder with history of multiple psychiatric
admissions.
2. History of three previous severe motor vehicle collisions.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Two pack per day smoker, lives alone. 

### Response:
{'Closed fracture of vault of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Closed fracture of acetabulum,Schizoaffective disorder, unspecified,Acute posthemorrhagic anemia,Retention of urine, unspecified,Pneumonia, organism unspecified,Other motor vehicle nontraffic accident involving collision with stationary object injuring driver of motor vehicle other than motorcycle,Traumatic pneumohemothorax without mention of open wound into thorax'}
