CHIEF COMPLAINT: hanging attempt

PRESENT ILLNESS: 22F s/p hanging attempt. Per report, boyfriend heard patient
scream, went to her room and found her attempting to hang
herself with a wire. BF pulled pt down then called EMS. EMS
reported depressed mental status with seizure-like
activity/posturing en route to OSH. She was intubated for airway
protection. Head and c-spine CT scans obtained were negative.
She was then transferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: HIV, ?Hep C, asthma, sarcoma in L arm s/p surgical excision and
radiation, heroin/cocaine abuse

MEDICATION ON ADMISSION: Albuterol inhaler prn

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Upon presentation to [**Hospital1 18**]:
Constitutional: Intubated and sedated
Chest: Clear to auscultation
Cardiovascular: Regular Rate and Rhythm, Normal first and
second heart sounds
Abdominal: Soft, Nontender

FAMILY HISTORY: 

SOCIAL HISTORY: heroin/cocaine abuse - per family report previous admissions for
drug treatment
Asphyxiation and strangulation,Suicide and self-inflicted injury by hanging,Asymptomatic human immunodeficiency virus [HIV] infection status,Asthma, unspecified type, unspecified,Opioid abuse, unspecified
Asphyxiation/strangulat,Injury-hanging,Asymp hiv infectn status,Asthma NOS,Opioid abuse-unspec
Admission Date:  [**2113-4-9**]              Discharge Date:   [**2113-4-11**]

Date of Birth:  [**2092-2-10**]             Sex:   F

Service: SURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 598**]
Chief Complaint:
hanging attempt

Major Surgical or Invasive Procedure:
none

History of Present Illness:
22F s/p hanging attempt. Per report, boyfriend heard patient
scream, went to her room and found her attempting to hang
herself with a wire. BF pulled pt down then called EMS. EMS
reported depressed mental status with seizure-like
activity/posturing en route to OSH. She was intubated for airway
protection. Head and c-spine CT scans obtained were negative.
She was then transferred to [**Hospital1 18**] for further care.

Past Medical History:
HIV, ?Hep C, asthma, sarcoma in L arm s/p surgical excision and
radiation, heroin/cocaine abuse

Social History:
heroin/cocaine abuse - per family report previous admissions for
drug treatment

Physical Exam:
Upon presentation to [**Hospital1 18**]:
Constitutional: Intubated and sedated
Chest: Clear to auscultation
Cardiovascular: Regular Rate and Rhythm, Normal first and
second heart sounds
Abdominal: Soft, Nontender


Pertinent Results:
[**2113-4-9**] 01:00PM   WBC-11.3* RBC-3.91* HGB-12.2 HCT-35.0* MCV-90
MCH-31.3 MCHC-34.9 RDW-13.7
[**2113-4-9**] 01:00PM   PLT COUNT-283
[**2113-4-9**] 01:00PM   PT-13.5* PTT-28.7 INR(PT)-1.2*
[**2113-4-9**] 01:09PM   GLUCOSE-64* LACTATE-1.7 NA+-140 K+-3.4*
CL--104 TCO2-23
Imaging:
*MRI brain: 1. No abnormal restricted diffusion to suggest acute
ischemia. 2. Major intracranial vessels patent.
3. No acute intracranial process.  4. Right maxillary mucus
retention cyst.
*CT HEAD: There is no evidence of hemorrhage, mass effect or
midline shift seen. The ventricles are slightly small in size
which could be related to patient's age but mild brain edema
could not be excluded. MRI can help for further assessment. The
basal cisterns are patent. There is no herniation seen.
Intubation is visualized.
*CT ANGIOGRAPHY NECK AND HEAD: CT angiography of the head and
neck demonstrates normal flow in the carotid and vertebral
arteries without stenosis, occlusion, dissection or evidence of
extravasation of contrast.  Vascular structures of the thoracic
inlet are well maintained.


Brief Hospital Course:
Patient was transferred from OSH after being intubated for
airway protection status post hanging attempt and seizure-like
activity/posturing en route to OSH. She had a CT head and neck
demonstrating no fractures and a CTA head/neck with bilateral
carotids and vertebral's patent. An MRI head/brain showed no
abnormal restricted diffusion to suggest acute ischemia. She was
admitted to the TSICU and was kept intubated overnight. On HD2
patient was extubated, initially requiring Precedex for
sedation, and this was weaned off. She demonstrated no evidence
of pneumonia on her chest xray and remained afebrile throughout
her ICU stay. Her leukocytosis at presentation is the result of
a reaction to trauma.  Preliminary MRSA testing was negative,
final results pending.

Her cervical spine was cleared once she was awake and able to
give a reliable exam.

She was evaluated by Psychiatry and was maintained on a 1:1
sitter throughout her admission. Standing Valium 10 mg daily was
started per Psychiatry. She is being recommended for inpatient
psych admission.

She was also seen by Social work for coping and emotional
support surrounding her trauma.



Medications on Admission:
Albuterol inhaler prn

Discharge Medications:
1. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
2-4 Puffs Inhalation Q4H (every 4 hours) as needed for wheeze.
2. nicotine 14 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr
Transdermal DAILY (Daily).
3. diazepam 10 mg Tablet Sig: One (1) Tablet PO Q 24H (Every 24
Hours).


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 44097**]

Discharge Diagnosis:
s/p Hanging attempt


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
You were admitted to the hospital following an attempted
hanging. You underwent cat scan imaging of your head and neck
and there were no injuries identified. You were monitored
closely in the ICU and remained stable and now being evaluated
by Psychiatry for admission to inpatient mental health facility.
Please call your doctor or return to the ER for any of the
following:
* You experience new chest pain, pressure, squeezing or
tightness.
* New or worsening cough or wheezing.
* If you are vomiting and cannot keep in fluids or your
medications.
* You are getting dehydrated due to continued vomiting,
diarrhea or other reasons.
* Signs of dehydration include dry mouth, rapid heartbeat or
feeling dizzy or faint when standing.
* You see blood or dark/black material when you vomit or have a
bowel movement.
* Your skin, or the whites of your eyes become yellow.
* You have shaking chills, or a fever greater than 101.5 (F)
degrees or 38(C) degrees.
* Any serious change in your symptoms, or any new symptoms that
concern you.
* Please resume all regular home medications and take any new
meds
as ordered.
* Do not drive or operate heavy machinery while taking any
narcotic pain medication.  You may have constipation when taking
narcotic pain medications (oxycodone, percocet, vicodin,
hydrocodone, dilaudid, etc.); you should continue drinking
fluids, you may take stool softeners, and should eat foods that
are high in fiber.
* Continue to ambulate several times per day.


Followup Instructions:
For any questions or concerns related to your recent hospital
stay please contact the Acute Care Surgery clinic at
[**Telephone/Fax (1) 600**] to determine if you need to be seen.


                             [**First Name8 (NamePattern2) **] [**Name8 (MD) **] MD [**MD Number(2) 601**]
{'Asphyxiation and strangulation,Suicide and self-inflicted injury by hanging,Asymptomatic human immunodeficiency virus [HIV] infection status,Asthma, unspecified type, unspecified,Opioid abuse, 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: hanging attempt

PRESENT ILLNESS: 22F s/p hanging attempt. Per report, boyfriend heard patient
scream, went to her room and found her attempting to hang
herself with a wire. BF pulled pt down then called EMS. EMS
reported depressed mental status with seizure-like
activity/posturing en route to OSH. She was intubated for airway
protection. Head and c-spine CT scans obtained were negative.
She was then transferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: HIV, ?Hep C, asthma, sarcoma in L arm s/p surgical excision and
radiation, heroin/cocaine abuse

MEDICATION ON ADMISSION: Albuterol inhaler prn

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Upon presentation to [**Hospital1 18**]:
Constitutional: Intubated and sedated
Chest: Clear to auscultation
Cardiovascular: Regular Rate and Rhythm, Normal first and
second heart sounds
Abdominal: Soft, Nontender

FAMILY HISTORY: 

SOCIAL HISTORY: heroin/cocaine abuse - per family report previous admissions for
drug treatment 

### Response:
{'Asphyxiation and strangulation,Suicide and self-inflicted injury by hanging,Asymptomatic human immunodeficiency virus [HIV] infection status,Asthma, unspecified type, unspecified,Opioid abuse, unspecified'}
