CHIEF COMPLAINT: 66 y/o male s/p MVC rollover, hit rail at 50mph, + LOC,
unrestrained.

PRESENT ILLNESS: 66 y/o male s/p MVC rollover, hit rail at 50mph, + LOC,
unrestrained. Patient was sent to an OSH where he was noted to
have an open right wrist fx, mulitple rib fx's and a patellar
dislocation of his left knee. CT head was reportedly negative
and he was sent to [**Hospital1 18**] for further evaluation and definitive
care.

MEDICAL HISTORY: none

MEDICATION ON ADMISSION: ASA 81'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen: NAD, AAOx3
HEENT: in hard c-collar
CV: RRR
Pulm: CTAB
Abd: soft, NT, ND
RUE: in volar splint, incision c/d/i
LUE: wound on elbow c/d/i dressed with DSD
LLE: incision c/d/i in [**Doctor Last Name 6587**] brace locked in extension

FAMILY HISTORY: N/C

SOCIAL HISTORY: No Tob, Occ EtOH
Closed fracture of multiple ribs, unspecified,Closed fracture of first cervical vertebra,Other open fractures of distal end of radius (alone),Closed fracture of patella,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Other alteration of consciousness
Fx mult ribs NOS-closed,Fx c1 vertebra-closed,Fx distal radius NEC-opn,Fracture patella-closed,Mv collision NOS-driver,Other alter consciousnes
Admission Date:  [**2114-2-21**]              Discharge Date:   [**2114-2-26**]

Date of Birth:  [**2047-3-28**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 4691**]
Chief Complaint:
66 y/o male s/p MVC rollover, hit rail at 50mph, + LOC,
unrestrained.

Major Surgical or Invasive Procedure:
1.  Irrigation and debridement of open right forearm
    fracture.
2.  Open reduction and internal fixation of radial shaft.
3.  Open reduction and internal fixation of distal radial
    ulnar joint.
4.  Open reduction and internal fixation of patella fracture
    with patella tendon avulsion and resection of the distal
    pole.


History of Present Illness:
66 y/o male s/p MVC rollover, hit rail at 50mph, + LOC,
unrestrained. Patient was sent to an OSH where he was noted to
have an open right wrist fx, mulitple rib fx's and a patellar
dislocation of his left knee. CT head was reportedly negative
and he was sent to [**Hospital1 18**] for further evaluation and definitive
care.

Past Medical History:
none

Social History:
No Tob, Occ EtOH

Family History:
N/C

Physical Exam:
Gen: NAD, AAOx3
HEENT: in hard c-collar
CV: RRR
Pulm: CTAB
Abd: soft, NT, ND
RUE: in volar splint, incision c/d/i
LUE: wound on elbow c/d/i dressed with DSD
LLE: incision c/d/i in [**Doctor Last Name 6587**] brace locked in extension

Pertinent Results:
[**2114-2-23**] 06:35AM BLOOD WBC-8.2 RBC-3.35* Hgb-10.0* Hct-29.4*
MCV-88 MCH-30.0 MCHC-34.2 RDW-13.7 Plt Ct-219
[**2114-2-22**] 08:25AM BLOOD Hct-34.1*
[**2114-2-22**] 02:57AM BLOOD WBC-8.7 RBC-3.74* Hgb-11.4* Hct-32.8*
MCV-88 MCH-30.6 MCHC-34.9 RDW-13.7 Plt Ct-264
[**2114-2-21**] 03:40PM BLOOD WBC-10.6 RBC-3.66* Hgb-11.1* Hct-32.7*
MCV-89 MCH-30.2 MCHC-33.8 RDW-13.5 Plt Ct-296
[**2114-2-23**] 06:35AM BLOOD Plt Ct-219
[**2114-2-22**] 02:57AM BLOOD Plt Ct-264
[**2114-2-21**] 03:40PM BLOOD Plt Ct-296
[**2114-2-21**] 03:40PM BLOOD PT-12.7 PTT-22.2 INR(PT)-1.1
[**2114-2-23**] 06:35AM BLOOD Glucose-126* UreaN-14 Creat-0.8 Na-138
K-3.6 Cl-103 HCO3-28 AnGap-11
[**2114-2-22**] 02:57AM BLOOD Glucose-170* UreaN-12 Creat-0.8 Na-133
K-3.7 Cl-99 HCO3-25 AnGap-13
[**2114-2-21**] 03:40PM BLOOD Amylase-50
[**2114-2-23**] 06:35AM BLOOD Calcium-8.2* Phos-1.8* Mg-2.1
[**2114-2-22**] 02:57AM BLOOD Calcium-8.4 Phos-2.7 Mg-1.9
[**2114-2-21**] 03:40PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG
Bnzodzp-NEG Barbitr-NEG Tricycl-NEG

Brief Hospital Course:
66 y/o male s/p MVC rollover, hit rail at 50mph, + LOC,
unrestrained. Patient was sent to an OSH where he was noted to
have an open right wrist fx, mulitple rib fx's and a patellar
dislocation of his left knee. CT head was reportedly negative
and he was sent to [**Hospital1 18**] for further evaluation and definitive
care.
At the [**Hospital1 18**] radiographic studies and physical exam revealed and
open galleazi fracture dislocation of the RUE, Multiple rib
fractures on the left side, both anteriorly and posteriorly, a
small left pleural effusion, acute comminuted oblique-sagittal
fracture through the right lateral mass of C1, entering the
spinal canal, but sparing the foramen transversarium, and a left
patellar fx. CT of the head revealed only a small subgaleal
hematoma. The patient was seen by neurosurgery who recommended a
hard collar for 12 weeks. The patient was then taken to the OR
with ortho for a 1.  Irrigation and debridement of open right
forearm fracture. 2.  Open reduction and internal fixation of
radial shaft.3.  Open reduction and internal fixation of distal
radialulnar joint. 4.  Open reduction and internal fixation of
patella fracturewith patella tendon avulsion and resection of
the distal pole.
He tolerated the procedure well and was transferred to the
floor. He was advanced to a regular diet and his pain was
controlled with IV then PO pain meds. He was able to be WBAT on
the LLE with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 6587**] brace locked in extension and was
assisted by PT. The small wound on his left elbow was dressed
with dry [**Last Name (un) 71507**] dressing and a volar splint was fashioned for
his right upper extremity. He continued to gain mobility and on
POD # 5 was cleared to go home with PT by PT. He will followup
with ortho trauma, ortho hand, neurosurgery, and trauma surgery.
He will remain in the LLE brace in extension, int he RUE volar
splint, and in the C-collar.


Medications on Admission:
ASA 81'

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
2. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3
hours) as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*
3. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
4. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q6H (every 6
hours).


Discharge Disposition:
Home With Service

Facility:
VNA Southeastern MA

Discharge Diagnosis:
s/p MVC
1. RUE open galeazzi fx
2. left patellar fx s/p ORIF
3. 8/9th rib fx
4. lat mass C1 fx


Discharge Condition:
Stable


Discharge Instructions:
[**Name8 (MD) **] M.D. if fever > 101.5, nausea, vomiting, shortness of
breath, chest pain, increased redness around incision or
drainage from incision. Keep knee immobilized in [**Doctor Last Name 6587**] brace
for 8 weeks. Change dressing to left elbow once a day with dry
sterile dressing and keep right arm in splint, non-weight
bearing. Remain in hard cervical collar for 12 weeks total.
Please followup with ortho trauma, ortho hand, trauma surgery,
neurosurgery, and your PCP.

Followup Instructions:
Please call Dr. [**Last Name (STitle) **] of trauma surgery to schedule a followup
in 2 weeks ([**Telephone/Fax (1) 22750**].
Please call Dr. [**Last Name (STitle) 1005**] of ortho trauma to schedule a followup
in 10 days ([**Telephone/Fax (1) 2007**].
Please call Dr. [**Last Name (STitle) **] of hand to schedule an appointment
([**Telephone/Fax (1) 2007**].
Please call Dr. [**Last Name (STitle) 548**] of Neurosurgery to schedule a followup in
2 weeks ([**Telephone/Fax (1) 88**].



Completed by:[**2114-2-26**]
{'Closed fracture of multiple ribs, unspecified,Closed fracture of first cervical vertebra,Other open fractures of distal end of radius (alone),Closed fracture of patella,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Other alteration of consciousness'}


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: 66 y/o male s/p MVC rollover, hit rail at 50mph, + LOC,
unrestrained.

PRESENT ILLNESS: 66 y/o male s/p MVC rollover, hit rail at 50mph, + LOC,
unrestrained. Patient was sent to an OSH where he was noted to
have an open right wrist fx, mulitple rib fx's and a patellar
dislocation of his left knee. CT head was reportedly negative
and he was sent to [**Hospital1 18**] for further evaluation and definitive
care.

MEDICAL HISTORY: none

MEDICATION ON ADMISSION: ASA 81'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen: NAD, AAOx3
HEENT: in hard c-collar
CV: RRR
Pulm: CTAB
Abd: soft, NT, ND
RUE: in volar splint, incision c/d/i
LUE: wound on elbow c/d/i dressed with DSD
LLE: incision c/d/i in [**Doctor Last Name 6587**] brace locked in extension

FAMILY HISTORY: N/C

SOCIAL HISTORY: No Tob, Occ EtOH 

### Response:
{'Closed fracture of multiple ribs, unspecified,Closed fracture of first cervical vertebra,Other open fractures of distal end of radius (alone),Closed fracture of patella,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Other alteration of consciousness'}
