CHIEF COMPLAINT: Motorcycle collision

PRESENT ILLNESS: 35 yo Male s/p [**Hospital **] transferred from [**Hospital 189**] Hospital for open
Right tibia fracture and closed Left ankle lateral malleolus
fracture.

MEDICAL HISTORY: h/o machete attack missing 3rd and 4th fingers of L hand distal
to PIP joint, GSW

MEDICATION ON ADMISSION: Ativan

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: n/a

SOCIAL HISTORY: unemployed on disability, five children, parallel history notes
he drinks 5-15 beers a day
Open fracture of shaft of tibia alone,Suicidal ideation,Fracture of lateral malleolus, closed,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Cocaine abuse, unspecified,Posttraumatic stress disorder
Fx tibia shaft-open,Suicidal ideation,Fx lateral malleolus-cl,Mv collis NOS-motorcycl,Cocaine abuse-unspec,Posttraumatic stress dis
Admission Date:  [**2120-8-11**]              Discharge Date:   [**2120-8-16**]

Date of Birth:  [**2084-12-12**]             Sex:   M

Service: ORTHOPAEDICS

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 16613**]
Chief Complaint:
Motorcycle collision

Major Surgical or Invasive Procedure:
[**2120-8-11**]: s/p open reduction internal fixation left distal
fibula and right tibia.


History of Present Illness:
35 yo Male s/p [**Hospital **] transferred from [**Hospital 189**] Hospital for open
Right tibia fracture and closed Left ankle lateral malleolus
fracture.

Past Medical History:
 h/o machete attack missing 3rd and 4th fingers of L hand distal
to PIP joint, GSW

Social History:
unemployed on disability, five children, parallel history notes
he drinks 5-15 beers a day

Family History:
n/a

Pertinent Results:
[**2120-8-11**] 07:05AM   FIBRINOGE-272
[**2120-8-11**] 07:05AM   PT-11.3 PTT-23.2 INR(PT)-0.9
[**2120-8-11**] 07:05AM   PLT COUNT-331
[**2120-8-11**] 07:05AM   WBC-14.6* RBC-4.42* HGB-13.9* HCT-40.9 MCV-93
MCH-31.4 MCHC-33.9 RDW-13.8
[**2120-8-11**] 07:05AM   ASA-NEG ETHANOL-148* ACETMNPHN-NEG
bnzodzpn-NEG barbitrt-NEG tricyclic-NEG
[**2120-8-11**] 07:05AM   LIPASE-22
[**2120-8-11**] 07:05AM   estGFR-Using this
[**2120-8-11**] 07:05AM   UREA N-12 CREAT-1.1
[**2120-8-11**] 07:18AM   HGB-14.9 calcHCT-45 O2 SAT-65 CARBOXYHB-4 MET
HGB-0
[**2120-8-11**] 07:18AM   GLUCOSE-103 LACTATE-2.3* NA+-146 K+-4.1
CL--106 TCO2-25
[**2120-8-11**] 07:18AM   PH-7.28*

Brief Hospital Course:
Mr [**Known lastname 85299**] was admitted to the ICU on [**2120-8-11**] after being
involved in a motorcycle collision.  On the day of admission he
underwent Irrigation and debridement right open tibial fracture
with Open reduction and internal fixation of the right tibia and
 open reduction and internal fixation left ankle fracture
without complication.  On [**2120-8-12**] he was transferred out of the
ICU onto the Orthopedic service.
The remainder of his hospitalization was unremarkable.  He made
steady progress with PT, tolerated a diet and his pain was
controlled with PO medications.  He will be discharge home WBAT
on RLE, NWB LLE and will continue Lovenox for 4 weeks for DVT
prophylaxis after being cleared for discharge by the physical
therapy service.


Medications on Admission:
Ativan

Discharge Disposition:
Home

Discharge Diagnosis:
1. Right open tibia fracture.
2. Left distal fibula fracture.


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).


Discharge Instructions:
Wound Care:
-Keep Incision dry.
-Do not soak the incision in a bath or pool.
-Staples will be removed at your first post-operative visit.

Activity:
-Continue to be non weight bearing on your left leg.
-Continue to be full weight bearing on your right leg.
-Do not remove cast.  Keep cast dry.

Other Instructions
- Resume your regular diet.
- Avoid nicotine products to optimize healing.
- Resume your home medications. Take all medications as
instructed.
- Continue taking the Lovenox to prevent blood clots.

-You have also been given Additional Medications to control your
pain.  Please allow 72 hours for refill of narcotic
prescriptions, so plan ahead.  You can either have them mailed
to your home or pick them up at the clinic located on [**Hospital Ward Name 23**] 2.
 We are not allowed to call in narcotic (oxycontin, oxycodone,
percocet) prescriptions to the pharmacy.   In addition, we are
only allowed to write for pain medications for 90 days from the
date of surgery.

- Narcotic pain medication may cause drowsiness.  Do not drink
alcohol while taking narcotic medications.  Do not operate any
motor vehicle or machinery while taking narcotic pain
medications.  Taking more than recommended may cause serious
breathing problems.

If you have questions, concerns or experience any of the below
danger signs then please call your doctor at [**Telephone/Fax (1) 1228**] or go
to your local emergency room.


Followup Instructions:
2 weeks in the [**Hospital **] clinic with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], NP.
Please call [**Telephone/Fax (1) 1228**] to make this appointment.


                             [**Name6 (MD) 13978**] [**Name8 (MD) **] MD [**MD Number(2) 16614**]

Completed by:[**2120-8-15**]
{'Open fracture of shaft of tibia alone,Suicidal ideation,Fracture of lateral malleolus, closed,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Cocaine abuse, unspecified,Posttraumatic stress disorder'}


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: Motorcycle collision

PRESENT ILLNESS: 35 yo Male s/p [**Hospital **] transferred from [**Hospital 189**] Hospital for open
Right tibia fracture and closed Left ankle lateral malleolus
fracture.

MEDICAL HISTORY: h/o machete attack missing 3rd and 4th fingers of L hand distal
to PIP joint, GSW

MEDICATION ON ADMISSION: Ativan

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: n/a

SOCIAL HISTORY: unemployed on disability, five children, parallel history notes
he drinks 5-15 beers a day 

### Response:
{'Open fracture of shaft of tibia alone,Suicidal ideation,Fracture of lateral malleolus, closed,Other motor vehicle traffic accident involving collision with motor vehicle injuring motorcyclist,Cocaine abuse, unspecified,Posttraumatic stress disorder'}
