CHIEF COMPLAINT: s/p Motorcycle crash

PRESENT ILLNESS: 54 yo male s/p motorcycle crash; reportedly struck by a vehicle;
denies LOC. He was taken to an area hospital where found to have
a comminuted pelvic fracture and pelvic hematoma. He was then
transferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: Emphysema

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: 
Closed fracture of acetabulum,Injury to other specified pelvic organs, without mention of open wound into cavity,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Open wound of buttock, without mention of complication,Other emphysema
Fracture acetabulum-clos,Pelvic organ inj NEC-cl,Mv collis NOS-motorcycl,Open wound of buttock,Emphysema NEC
Admission Date:  [**2164-4-19**]              Discharge Date:   [**2164-5-1**]

Date of Birth:  [**2110-4-18**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 4691**]
Chief Complaint:
s/p Motorcycle crash

Major Surgical or Invasive Procedure:
[**2164-4-23**] ORIF Left acetabulum


History of Present Illness:
54 yo male s/p motorcycle crash; reportedly struck by a vehicle;
denies LOC. He was taken to an area hospital where found to have
a comminuted pelvic fracture and pelvic hematoma. He was then
transferred to [**Hospital1 18**] for further care.

Past Medical History:
Emphysema

Family History:
Noncontributory

Pertinent Results:
Upon admission:

[**2164-4-19**] 10:09PM   HCT-32.8*
[**2164-4-19**] 10:09PM   PT-12.9 PTT-31.3 INR(PT)-1.1
[**2164-4-19**] 04:17PM   GLUCOSE-175* LACTATE-3.2* NA+-140 K+-4.6
CL--105 TCO2-22
[**2164-4-19**] 04:10PM   UREA N-13 CREAT-1.0 SODIUM-139 POTASSIUM-4.6
CHLORIDE-107 TOTAL CO2-21* ANION GAP-16
[**2164-4-19**] 04:10PM   WBC-26.8* RBC-4.47* HGB-13.0* HCT-38.8*
MCV-87 MCH-29.0 MCHC-33.5 RDW-13.8
[**2164-4-19**] 04:10PM   PLT COUNT-452*
[**2164-4-19**] 04:10PM   PT-14.1* PTT-34.0 INR(PT)-1.2*

CT ABD W&W/O C  [**2164-4-19**] 4:24 PM

IMPRESSION:

1. Extensively comminuted pelvic fractures, including two column
left acetabular fracture. Large pelvic hematoma extending into
the retroperitoneum, with no definite evidence of active
extravasation.

2. Severe lung emphysema.

3. No evidence of solid organ injury.

CTA CHEST W&W/O C&RECONS, NON-CORONARY  [**2164-4-24**] 8:31 PM
IMPRESSION:

1. No pulmonary embolism is noted.

2. No clot is noted within the venous system including the IV
and iliac veins. The left external iliac vein is compressed by
the left pelvic hematoma, but is patent.

3. Status post ORIF of the left acetabulum and the left iliac
[**Doctor First Name 362**] with hematoma within the obturator internus, iliacus and
the psoas muscles.

4. Multiple simple cysts of the liver.

5. Small bilateral pleural effusion and dependent atelectatic
changes at both lung bases.

6. Both lungs demonstrate diffuse paraseptal emphysema. The
lingular lobe is nearly completely replaced by a large bulla.

7. Fluid collection is noted within the left lateral part of
lower abdominal wall and posterior to the left psoas muscle.
This is posttraumatic and not significantly changed.


Brief Hospital Course:
He was admitted to the Trauma Service. Orthopedics was consulted
given his injuries; managed initially in traction until
hemodynamically stable. He was taken to the operating room
several days later for repair of his acetabular fracture; there
were no intraoperative complications. He did experience pain
control issues; initially refusing to take narcotics. He also
refused to work with Physical therapy because of his pain. After
many discussions  he did eventually agree to take narcotics;
started out with short acting narcotics and eventually added
long acting narcotics with better control. He was able to then
work better with Physical and Occupational therapy. Wound care
nurse was also consulted for wound on his foot; Accuzyme was
recommended. He will follow up with Orthopedics in 2 weeks for
removal of staples and follow up with Dr. [**Last Name (STitle) **] for his foot
ulcer in 2 weeks.


Discharge Medications:
1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2)
Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for
constipation.
2. Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day)
as needed for constipation.
3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
4. Hydromorphone 4 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3
hours) as needed for breakthrough pain.
Disp:*90 Tablet(s)* Refills:*0*
5. Enoxaparin 40 mg/0.4 mL Syringe Sig: Forty (40) MG
Subcutaneous DAILY (Daily).
6. Oxycodone 10 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*
7. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours): must take with food.
Disp:*120 Tablet(s)* Refills:*0*
8. Papain-Urea 830,000-10 unit/g-% Ointment Sig: One (1) Appl
Topical DAILY (Daily): Apply to foot wound daily as directed.
Disp:*1 * Refills:*2*


Discharge Disposition:
Home

Discharge Diagnosis:
s/p Motrcycle crash
Left acetabular fracture
Right buttock laceration

Discharge Condition:
Good

Discharge Instructions:
You may continue your home medications.

Your foot dressing will need to be changed daily as directed.

Continue your daily Lovenox injections for a total of 4 months
after your surgery to prevent blood clots.  You may ambulate
with touch-down weight-bearing in your left leg, and you have no
limitations on your right leg range of motion.

You may use dry sterile gauze daily to keep your incisions clean
and dry.

[**Name8 (MD) **] MD or visit your nearest emergency department if you
develop any of the following: fevers, increased redness or
drainage from your incisions, chest pain, shortness of breath,
intractable abdominal pain, nausea, vomiting, or any other
symptoms that concern you or your family.

Followup Instructions:
Follow-up with Dr. [**Last Name (STitle) 1005**] of Orthopaedic Surgery 2 weeks from
your surgery date.  Call ([**Telephone/Fax (1) 5238**] to schedule this
appointment.

Follow-up with Dr. [**Last Name (STitle) **] of Trauma Surgery in 2 weeks if
needed.  Call ([**Telephone/Fax (1) 68195**] to schedule this appointment.


Completed by:[**2164-5-1**]
{'Closed fracture of acetabulum,Injury to other specified pelvic organs, without mention of open wound into cavity,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Open wound of buttock, without mention of complication,Other emphysema'}


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 Motorcycle crash

PRESENT ILLNESS: 54 yo male s/p motorcycle crash; reportedly struck by a vehicle;
denies LOC. He was taken to an area hospital where found to have
a comminuted pelvic fracture and pelvic hematoma. He was then
transferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: Emphysema

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY:  

### Response:
{'Closed fracture of acetabulum,Injury to other specified pelvic organs, without mention of open wound into cavity,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Open wound of buttock, without mention of complication,Other emphysema'}
