CHIEF COMPLAINT: s/p stab wounds left chest, back

PRESENT ILLNESS: 24 year old male who was transferred to [**Hospital1 18**] from [**Hospital3 25354**].

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: on long spine board, in c-collar, NAD
head NC/AT, PERRLA, EOMI, OP clear TMs clear
trachea midline, cspine nontender
breath sounds = bilaterally
2 <2cm lacerations left axilla, ~3cm laceration left ~T3/4
abd soft, nontender, +BS
no spontaneous movement BLE, flaccid paralysis, areflexic BLE
poor rectal tone, guiac neg
+ priapism
decreased sensation from approx 3cm below nipple-line inferiorly
A&Ox3, CN2-12 intact

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: +EtOH, no tobacco, drugs
T1-T6 level with other specified spinal cord injury,Traumatic pneumothorax without mention of open wound into thorax,Open wound of chest (wall), without mention of complication,Traumatic subcutaneous emphysema,Open wound of back, without mention of complication,Assault by cutting and piercing instrument,Closed fracture of one rib
T1-t6 spin cord inj NEC,Traum pneumothorax-close,Open wound of chest,Traum subcutan emphysema,Open wound of back,Assault-cutting instr,Fracture one rib-closed
Admission Date:  [**2194-7-18**]              Discharge Date:   [**2194-7-25**]

Date of Birth:  [**2169-12-23**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1556**]
Chief Complaint:
s/p stab wounds left chest, back

Major Surgical or Invasive Procedure:
Tube thoracostomy (chest tube) Left


History of Present Illness:
24 year old male who was transferred to [**Hospital1 18**] from [**Hospital3 25354**].

Social History:
+EtOH, no tobacco, drugs

Family History:
noncontributory

Physical Exam:
on long spine board, in c-collar, NAD
head NC/AT, PERRLA, EOMI, OP clear TMs clear
trachea midline, cspine nontender
breath sounds = bilaterally
2 <2cm lacerations left axilla, ~3cm laceration left ~T3/4
abd soft, nontender, +BS
no spontaneous movement BLE, flaccid paralysis, areflexic BLE
poor rectal tone, guiac neg
+ priapism
decreased sensation from approx 3cm below nipple-line inferiorly
A&Ox3, CN2-12 intact

Pertinent Results:
CXR [**7-18**]: PORTABLE AP CHEST RADIOGRAPH: A left-sided chest tube
is seen with the tip positioned in the left middle lung zone. A
small amount of subcutaneous air is seen adjacent to the entry
point. A tiny apical pneumothorax is noted. No pleural effusion
is seen. The cardiac and mediastinal contours are within normal
limits. A left-sided rib fracture is noted. The soft tissues are
otherwise normal. Pulmonary vasculature is within normal limits.

IMPRESSION: Left-sided chest tube is seen, with the tip
positioned in the
left middle lung zone adjacent to the mediastinum. A tiny apical
pneumothorax is noted on the left. A left-sided rib fracture is
also noted.

MRI TSpine [**7-18**]:IMPRESSION:
Evidence of dorsal dural tear at the T5-6 level with laceration
of the [**Month/Year (2) **] cord at this level. There also appears to be a
small posterior epidural collection as described above, which
likely represents hematoma. Increased signal intensity within
the soft tissues is consistent with edema.

CT Chest, Abd, Pelvis:
IMPRESSION:  1) Subcutaneous emphysema in the soft tissues of
the left chest and back, with tiny left pleural effusion and
hematoma in left lung.
2) No evidence of splenic, left kidney, or colonic injury. No
evidence of
abdominal organ injury.


Brief Hospital Course:
The patient was transferred from [**Hospital6 204**] after
stab wounds to the axilla & back. He was noted to have an
approximately T4 [**Hospital6 **] level immediately after he was stabbed.
He was hemodynamically stable during transfer and remained so
throughout his stay.
Chest CT in the ED revealed left pneumo/hemothorax and a left
chest tube was placed in the ED with approximately 500mL bloody
return.
He was admitted to the neuro ICU and was seen by neurosurgery.
He was started on IV steroids as per [**Hospital1 18**] protocol, and was
continued on keflex IV.
MR [**First Name (Titles) 654**] [**Last Name (Titles) **] cord laceration at T5/6.
On HD 2 he was transferred to the floor. His Cspine was cleared
and he was fitted with a TLSO brace and seen by PT/OT who worked
on transfers and ADLs. He was started on a bowel/bladder
regimen.
Neurosurgery stated that there was no surgical intervention
indicated.
On HD 6 patient was changed from SQ Heparin tid to Lovenox 30mg
qd; the decision to place IVC filter was deferred early during
his hospitalization. He was transferred to [**Hospital 4820**] rehab for
[**Hospital **] cord injuries.

Medications on Admission:
none

Discharge Medications:
1. 1st step matress
To be delivered ASAP
2. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every
4 to 6 hours) as needed.
3. Lovenox 30mg subcutaneous injection qd (everyday)
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
5. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2)
Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed.
6. Glycerin (Adult) 3 g Suppository Sig: One (1) Suppository
Rectal PRN (as needed).
7. Morphine 2 mg/mL Syringe Sig: 2-4 mg Injection Q4H (every 4
hours) as needed.
8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed for pain.


Discharge Disposition:
Extended Care

Facility:
[**Hospital6 85**] - [**Location (un) 86**]

Discharge Diagnosis:
pneumothorax, hemothorax
[**Location (un) **] cord injury T5-6


Discharge Condition:
Good

Discharge Instructions:
Use your brace as instructed by physical therapy.


Followup Instructions:
With the neurosurgery department as needed. Please call ([**Telephone/Fax (1) 18865**] to schedule a follow-up appointment.



Completed by:[**2194-7-25**]
{'T1-T6 level with other specified spinal cord injury,Traumatic pneumothorax without mention of open wound into thorax,Open wound of chest (wall), without mention of complication,Traumatic subcutaneous emphysema,Open wound of back, without mention of complication,Assault by cutting and piercing instrument,Closed fracture of one rib'}


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 stab wounds left chest, back

PRESENT ILLNESS: 24 year old male who was transferred to [**Hospital1 18**] from [**Hospital3 25354**].

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: on long spine board, in c-collar, NAD
head NC/AT, PERRLA, EOMI, OP clear TMs clear
trachea midline, cspine nontender
breath sounds = bilaterally
2 <2cm lacerations left axilla, ~3cm laceration left ~T3/4
abd soft, nontender, +BS
no spontaneous movement BLE, flaccid paralysis, areflexic BLE
poor rectal tone, guiac neg
+ priapism
decreased sensation from approx 3cm below nipple-line inferiorly
A&Ox3, CN2-12 intact

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: +EtOH, no tobacco, drugs 

### Response:
{'T1-T6 level with other specified spinal cord injury,Traumatic pneumothorax without mention of open wound into thorax,Open wound of chest (wall), without mention of complication,Traumatic subcutaneous emphysema,Open wound of back, without mention of complication,Assault by cutting and piercing instrument,Closed fracture of one rib'}
