CHIEF COMPLAINT: 

PRESENT ILLNESS: A 34-year-old male status post
high speed motor vehicle crash unrestrained driver.  There
was some loss of consciousness.  He was verbal at the scene
with altered mental status.  He was intubated at the scene
and brought to the [**Hospital1 69**].  He
was hemodynamically stable upon arrival.

MEDICAL HISTORY: Noncontributory.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Cerebellar or brain stem contusion without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Traumatic shock,Pneumonitis due to inhalation of food or vomitus,Pneumonia due to Streptococcus, unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Laceration of skin of eyelid and periocular area,Open wound of lip, without mention of complication
Cerebell contus-brf coma,Lung contusion-closed,Traumatic shock,Food/vomit pneumonitis,Streptococcal pneumn NOS,Mv collision NOS-driver,Lac eyelid skn/perioculr,Open wound of lip
Admission Date:  [**2103-12-9**]       Discharge Date:  [**2103-12-27**]

Date of Birth:   [**2070-11-23**]       Sex:  M

Service:  Trauma Surgery

HISTORY OF PRESENT ILLNESS:  A 34-year-old male status post
high speed motor vehicle crash unrestrained driver.  There
was some loss of consciousness.  He was verbal at the scene
with altered mental status.  He was intubated at the scene
and brought to the [**Hospital1 69**].  He
was hemodynamically stable upon arrival.

PAST MEDICAL HISTORY:  Noncontributory.

ALLERGIES:  No known drug allergies.

MEDICATIONS:  None.

PHYSICAL EXAMINATION:  Temperature 98.8, heart rate 88, blood
pressure 150/palp, 99% with an endotracheal tube in place.
[**Location (un) 2611**] coma score of 3.  HEENT:  Pupils are equal, round,
and reactive to light 3 mm bilaterally.  Two cm laceration in
the right forehead, tympanic membrane clear.  Lungs:
Decreased breath sounds on the left side.  Cor:  Regular,
rate, and rhythm.  Rectal:  Guaiac negative.  Pelvis:
Stable.  Extremities:  No deformities.  Palpable pulses.

LABORATORY DATA:  Hematocrit 40, white blood cell count 25,
platelets 312, INR 1.1.  Electrolytes were within normal
limits.

Chest x-ray revealed a wide mediastinum and a collapsed right
lower lobe and a left pneumothorax.  Pelvis x-ray was
negative.  Head CT scan showed a left frontal subarachnoid
hemorrhage.  C spine film showed a very slight C4-C5
anterolisthesis with no fractures.  Chest CT scan showed a
right lower lobe collapse, aorta was okay.  Abdominal CT scan
was negative.

The patient was admitted to the Intensive Care Unit for
critical care and had bilateral chest tubes placed.
Neurosurgery consult was obtained for the subarachnoid
hemorrhage.  They repeated a head CT scan in 24 hours which
showed no expansion.  .................... Cardiology consult
was obtained.  Echocardiogram was done which revealed no
evidence of tamponade.  The patient had multiple
bronchoscopies performed with significant suctioning of
mucus.

Neurosurgery had initially placed an intracranial pressure
monitor for the subarachnoid hemorrhage.  Due to ICPs well
controlled, the monitor was removed.  The patient was
extremely difficult to wean off the ventilator.  It was
thought that he had an aspiration event.  Per Neurosurgery
recommendation, subQ Heparin was started on [**12-15**],
based on the head CT scan readings.

Patient had an evolving ARDS picture which required prolonged
intubation.  Patient was agitated and difficult to extubate.
He was finally extubated on [**12-19**].  He was transferred
to the Surgical Floor on [**12-21**].  Nutrition consult was
obtained.  Tube feedings were started.  After the modified
barium swallow test was passed, the patient was started on
regular diet.  Patient was worked with aggressively with
occupational and physical therapy services.

Patient was stable at the time of discharge.  The condition
on discharge was stable.

DISCHARGE MEDICATIONS:  Aspirin 81 mg q day, subQ Heparin
5,000 units [**Hospital1 **].

DISCHARGE STATUS:  Rehabilitation facility.

FOLLOWUP:  The patient is to followup .................... in
two weeks.

DISCHARGE DIAGNOSES:  Status post motor vehicle crash with
left subarachnoid hemorrhage found with thoraces, prolonged
intubation aspiration.






                            [**Name6 (MD) 19851**] [**Name8 (MD) 19852**], M.D.  [**MD Number(1) 19853**]

Dictated By:[**Name8 (MD) 1308**]
MEDQUIST36

D:  [**2103-12-27**]  08:26
T:  [**2103-12-27**]  08:43
JOB#:  [**Job Number 45443**]
{'Cerebellar or brain stem contusion without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Traumatic shock,Pneumonitis due to inhalation of food or vomitus,Pneumonia due to Streptococcus, unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Laceration of skin of eyelid and periocular area,Open wound of lip, without mention of complication'}


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: A 34-year-old male status post
high speed motor vehicle crash unrestrained driver.  There
was some loss of consciousness.  He was verbal at the scene
with altered mental status.  He was intubated at the scene
and brought to the [**Hospital1 69**].  He
was hemodynamically stable upon arrival.

MEDICAL HISTORY: Noncontributory.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Cerebellar or brain stem contusion without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Traumatic shock,Pneumonitis due to inhalation of food or vomitus,Pneumonia due to Streptococcus, unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Laceration of skin of eyelid and periocular area,Open wound of lip, without mention of complication'}
