CHIEF COMPLAINT: s/p trauma (ATV pinned patient with LOC x 10 min)

PRESENT ILLNESS: 47M who fell backward off truck bed while at work and then was
pinned by ATV when it fell upon him.  Reportedly, he was
unconscious at the scene for about 10 minutes & was intubated by
med flight en route for combativeness on transfer to [**Hospital1 18**].  No
reported seizures or hemodynaminc instability prior to arrival
at [**Hospital1 18**].

MEDICAL HISTORY: none

MEDICATION ON ADMISSION: unknown

ALLERGIES: Penicillins

PHYSICAL EXAM: Afeb 96  114/70  12 100% (on AC)
Intubated sedated
RRR
CTA bilat
Soft nontender abdomen
Neuro: Had purposely moved all extremities prior to sedation for
intubation

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: +etOH (4 per day)
+cigs
Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Closed fracture of six ribs,Unspecified intestinal obstruction,Cardiac arrest,Other pulmonary embolism and infarction,Intestinal infection due to Clostridium difficile,Other and unspecified alcohol dependence, unspecified,Contusion of back,Abrasion or friction burn of elbow, forearm, and wrist, without mention of infection,Other accidental fall from one level to another,Struck accidentally by falling object
Cl skul base fx/brf coma,Lung contusion-closed,Fracture six ribs-closed,Intestinal obstruct NOS,Cardiac arrest,Pulm embol/infarct NEC,Int inf clstrdium dfcile,Alcoh dep NEC/NOS-unspec,Back contusion,Abrasion forearm,Fall-1 level to oth NEC,Struck by falling object
Admission Date:  [**2103-7-4**]              Discharge Date:   [**2103-7-21**]

Date of Birth:  [**2056-7-2**]             Sex:   M

Service: SURGERY

Allergies:
Penicillins

Attending:[**First Name3 (LF) 5880**]
Chief Complaint:
s/p trauma (ATV pinned patient with LOC x 10 min)

Major Surgical or Invasive Procedure:
bronchoscopy [**7-10**]

History of Present Illness:
47M who fell backward off truck bed while at work and then was
pinned by ATV when it fell upon him.  Reportedly, he was
unconscious at the scene for about 10 minutes & was intubated by
med flight en route for combativeness on transfer to [**Hospital1 18**].  No
reported seizures or hemodynaminc instability prior to arrival
at [**Hospital1 18**].

Past Medical History:
none

Social History:
+etOH (4 per day)
+cigs

Family History:
noncontributory

Physical Exam:
Afeb 96  114/70  12 100% (on AC)
Intubated sedated
RRR
CTA bilat
Soft nontender abdomen
Neuro: Had purposely moved all extremities prior to sedation for
intubation

Pertinent Results:
[**7-4**] CT head: L frontal SAH, R occipital SDH, nondisplaced
occipital skull fracture
C spine: neg
CT C/A/P: right 3rd-8th rib fractures with assoc RUL contusion

Brief Hospital Course:
Was loaded with dilantin in ED and then admitted to TSICU for
vent management after initial trauma evaluation.  Neurosurgery
was consulted, and followed patient with serial CT scans.  Due
to bleeding, SQ heparin was held until HD #4 (when CT head was
stable) & pneumoboots were used to prophylax vs DVTs.  The
patient remained intubated until HD #14 ([**7-17**]), since he
developed copious pulmonary secretions (requiring therapeutic
bronch on [**7-10**]).  His ICU course was also significant for
agitation, leukocytosis & high fevers (despite tx with levaquin
for h flu pneumonia).  After extubation, he did very well & was
eventually transferred to the floor in good condition on HD #16.
 His floor course was relatively unremarkable (passed bedside
swallow evaluation, cleared for home by PT) until the afternoon
of [**7-21**], when suddenly became unresponsive and hypoxic while
working with PT.  Initial ABG & clinical story was consistent
with a massive pulmonary embolus.  Despite initiation of CPR
immediately, the patient could not be revived & was pronounced
at 1407 after 30 minutes of CPR.  The family & the medical
examiner were both notified.

Medications on Admission:
unknown

Discharge Medications:
n/a

Discharge Disposition:
Expired

Discharge Diagnosis:
subdural hematoma
subarachnoid hematoma
occipital/basilar skull fracture
multiple rib fractures
pulmonary contusion
respiratory failure
pleural effusion
haemophilus pneumonia
ileus
DVT/PE

Discharge Condition:
deceased

Discharge Instructions:
n/a

Followup Instructions:
n/a


Completed by:[**2103-10-8**]
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Closed fracture of six ribs,Unspecified intestinal obstruction,Cardiac arrest,Other pulmonary embolism and infarction,Intestinal infection due to Clostridium difficile,Other and unspecified alcohol dependence, unspecified,Contusion of back,Abrasion or friction burn of elbow, forearm, and wrist, without mention of infection,Other accidental fall from one level to another,Struck accidentally by falling object'}


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 trauma (ATV pinned patient with LOC x 10 min)

PRESENT ILLNESS: 47M who fell backward off truck bed while at work and then was
pinned by ATV when it fell upon him.  Reportedly, he was
unconscious at the scene for about 10 minutes & was intubated by
med flight en route for combativeness on transfer to [**Hospital1 18**].  No
reported seizures or hemodynaminc instability prior to arrival
at [**Hospital1 18**].

MEDICAL HISTORY: none

MEDICATION ON ADMISSION: unknown

ALLERGIES: Penicillins

PHYSICAL EXAM: Afeb 96  114/70  12 100% (on AC)
Intubated sedated
RRR
CTA bilat
Soft nontender abdomen
Neuro: Had purposely moved all extremities prior to sedation for
intubation

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: +etOH (4 per day)
+cigs 

### Response:
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness,Contusion of lung without mention of open wound into thorax,Closed fracture of six ribs,Unspecified intestinal obstruction,Cardiac arrest,Other pulmonary embolism and infarction,Intestinal infection due to Clostridium difficile,Other and unspecified alcohol dependence, unspecified,Contusion of back,Abrasion or friction burn of elbow, forearm, and wrist, without mention of infection,Other accidental fall from one level to another,Struck accidentally by falling object'}
