CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 37 year-old
male restrained truck driver in a single vehicle rollover.
The patient had loss of consciousness for an indeterminate
time.  Extrication time 45 minutes.  Denies ETOH or drug
usage.  Last meal was about twelve hours before the accident.
[**Location (un) 2611**] Coma scale was 15.

MEDICAL HISTORY: Status post spiral tibial fracture
with rod.  Status post lymph node biopsy of the neck.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Closed dislocation of acromioclavicular (joint),Rotator cuff (capsule) sprain,Motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle
Disloc acromioclavic-cl,Sprain rotator cuff,Loss control mv acc-driv
Admission Date:  [**2183-9-19**]       Discharge Date:  [**2183-9-22**]

Date of Birth:   [**2146-6-15**]       Sex:  M

Service:  TRAUMA SURGERY

HISTORY OF PRESENT ILLNESS:  The patient is a 37 year-old
male restrained truck driver in a single vehicle rollover.
The patient had loss of consciousness for an indeterminate
time.  Extrication time 45 minutes.  Denies ETOH or drug
usage.  Last meal was about twelve hours before the accident.
[**Location (un) 2611**] Coma scale was 15.

PAST MEDICAL HISTORY:  Status post spiral tibial fracture
with rod.  Status post lymph node biopsy of the neck.

ALLERGIES:  No known drug allergies.

MEDICATIONS:  Occasional valium.

PHYSICAL EXAMINATION:  Temperature 35.4 degrees Celsius.
Blood pressure 150/80.  Pulse 70.  Respiratory rate 18.  100%
on room air oxygen saturation.  Neurological examination
decreased sensation to pin prick plus light touch across the
right anterior elbow and down the right arm.  3 to 5 strength
throughout on the right arm.  The patient had also had some
decreased sensation in the right leg from prior surgery.
Babinski was absent bilaterally, no clonus.  HEENT pupils 3
to 2 mm bilaterally.  Tympanic membranes were clear
bilaterally.  FAce is stable.  Atraumatic.  No malocclusion
of the jaw.  Chest was clear to auscultation bilaterally.
Cardiac was regular rate and rhythm.  Normal S1 and S2.
Gastrointestinal was soft, nontender, nondistended.  Rectal
with normal tone and guaiac negative.  Extremities no
clubbing, cyanosis or edema.  There was +2 radial, ulnar as
well as dorsalis pedis pulse and posterior tibial pulses all
bilaterally.  Full range of motion all extremities.

LABORATORY:  The patient had a white blood cell count of 9,
hematocrit 44, platelets 220, PT 13, partial thromboplastin
time 24.  Arterial blood gas values were pH 7.4, 0, PCO2 37,
AO2 of 201, bicarbonate 24, base deficit of 0.  Sodium 141,
potassium 4, chloride 105, bicarbonate of 21, BUN 18,
creatinine 1.1.  Amylase was 30, blood serum toxicology was
positive for benzodiazepines.  Urinalysis was normal.
Radiographic films, head CT negative.  Chest CT negative.
Possible right scapular/thoracic dislocation.  Abdominal CT
negative.  C spine CT negative.  Plain films TL spine
negative.  Right shoulder plain films negative.  C spine 3
views plain films, all negative for all views.  Left hand
plain film negative.

HOSPITAL COURSE:  The patient was consulted in conjunction
with orthopedics surgery who evaluated the patient.
Assessment included possible C spine spinal cord injury as
well as additional right brachial plexus injury.  Therefore
the patient was started on steroids for spinal cord injury
protocol with intravenous Solu-Medrol first with a loading
dose, then with 5.4 mg per kilogram per hour for 23 hours.
The patient was maintained in C collar at all times.  C spine
of the MR was also performed as well as right shoulder MR as
well as T spine of MR.  MRI of the CNT spines were all
negative.  MR of the right shoulder showed a slight AC right
shoulder joint separation as well as a partial tear of the
right rotator cuff.  On the 24th neurology was consulted
regarding the patient's continued though improving right arm
weakness.  Recommendations were to decrease pain medications,
any sedative medications, to continue hard cervical collar
until C spine flexion and extension films were performed to
clear cervical spine, continue on the intravenous steroids as
he had been improving with.

C spine flexion and extension views were performed, which
were within normal limits.  Therefore the patient was cleared
and C collar was taken off for C spine.  The patient was able
to ambulate out of bed and therefore his intravenous was
heplocked and diet was advanced to normal diet.  The patient
was cleared by neurology and also cleared by orthopedics for
discharge to home.  The patient is to remain in the right arm
sling.  The patient is to follow up with is orthopedic
surgeon within two weeks.

DISCHARGE CONDITION:  Good.  The patient will be discharged
to home.

DISCHARGE DIAGNOSIS:
Subluxation of the right acromioclavicular joint, most likely
musculotendinous.  Junction injury of the supraspinatus.  No
frank tears.

DISCHARGE MEDICATIONS:  Percocet one tab po q 4 to 6 hours as
needed for pain.  As well as Ibuprofen 800 mg po t.i.d. as
needed for pain.






                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2213**], M.D.  [**MD Number(1) 2214**]

Dictated By:[**Last Name (NamePattern1) 30578**]
MEDQUIST36

D:  [**2183-9-22**]  09:55
T:  [**2183-9-22**]  10:23
JOB#:  [**Job Number 21046**]
{'Closed dislocation of acromioclavicular (joint),Rotator cuff (capsule) sprain,Motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle'}


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: The patient is a 37 year-old
male restrained truck driver in a single vehicle rollover.
The patient had loss of consciousness for an indeterminate
time.  Extrication time 45 minutes.  Denies ETOH or drug
usage.  Last meal was about twelve hours before the accident.
[**Location (un) 2611**] Coma scale was 15.

MEDICAL HISTORY: Status post spiral tibial fracture
with rod.  Status post lymph node biopsy of the neck.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Closed dislocation of acromioclavicular (joint),Rotator cuff (capsule) sprain,Motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle'}
