CHIEF COMPLAINT: Pedestrian struck

PRESENT ILLNESS: 53F brought to [**Hospital1 18**] ED via ambulance as pedestrian struck by a
car, +EtOH, +LOC.  Upon arrival to [**Hospital1 18**] ED, the patient was
found to be extremetly agitated and combative.  She did not give
a history and did not endorse any particular pain.  She did
complain of shortness of breath.

MEDICAL HISTORY: Alcohol abuse

MEDICATION ON ADMISSION: Denies

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: On admission:

FAMILY HISTORY: Non-contributory

SOCIAL HISTORY: Patient reports to be homeless, living mostly [**Location (un) 84022**]. She has a significant history of alcohol abuse, for
which she has been cared for at [**Hospital1 18**] on multiple occasions for
detox and other related issues.
Contusion of face, scalp, and neck except eye(s),Concussion with loss of consciousness of unspecified duration,Open wound of scalp, without mention of complication,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Alcohol abuse, unspecified,Anemia, unspecified
Contusion face/scalp/nck,Concussion w coma NOS,Open wound of scalp,Mv coll w pedest-pedest,Alcohol abuse-unspec,Anemia NOS
Admission Date:  [**2199-2-1**]              Discharge Date:   [**2199-2-2**]

Date of Birth:  [**2145-11-23**]             Sex:   F

Service: SURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 371**]
Chief Complaint:
Pedestrian struck

Major Surgical or Invasive Procedure:
Endotracheal intubation, [**2199-2-1**]


History of Present Illness:
53F brought to [**Hospital1 18**] ED via ambulance as pedestrian struck by a
car, +EtOH, +LOC.  Upon arrival to [**Hospital1 18**] ED, the patient was
found to be extremetly agitated and combative.  She did not give
a history and did not endorse any particular pain.  She did
complain of shortness of breath.

Past Medical History:
Alcohol abuse

Social History:
Patient reports to be homeless, living mostly [**Location (un) 84022**]. She has a significant history of alcohol abuse, for
which she has been cared for at [**Hospital1 18**] on multiple occasions for
detox and other related issues.

Family History:
Non-contributory

Physical Exam:
On admission:

GEN: Agitated and combative. C-collar in place.
HEENT: R. forehead contusion, laceration.  PERRL, 4->3mm. TMs
clear.
CV: RRR
Pulm: CTAB. No chest wall tenderness or crepitus.
Abd: Soft, nondistended, nontender.
GU: No blood at urethral meatus.
MSK: Pelvis stable. Compartments soft. DP pulses palpable b/l.

(FAST: negative)

On discharge, exam unchanged from above.



Pertinent Results:
LABORATORY

On admission:

WBC-11.8* RBC-3.44* Hgb-11.7* Hct-35.7* MCV-104* MCH-34.0*
MCHC-32.8 RDW-14.8 Plt Ct-303
UreaN-16 Creat-0.8
[**Last Name (un) **] pO2-41* pCO2-58* pH-7.34* calTCO2-33* Base XS-3
Comment-GREEN TOP
Glucose-86 Lactate-1.7 Na-144 K-3.9 Cl-100
Hgb-12.8 calcHCT-38 O2 Sat-65 COHgb-8* MetHgb-0

Blood Tox: ASA-NEG Ethanol-281* Acetmnp-NEG Bnzodzp-NEG
Barbitr-NEG

On discharge:

WBC-7.7 RBC-3.04* Hgb-10.7* Hct-31.2* MCV-103* MCH-35.0*
MCHC-34.1 RDW-14.8 Plt Ct-254
PT-11.5 PTT-31.4 INR(PT)-1.1
Glucose-75 UreaN-19 Creat-0.7 Na-145 K-3.6 Cl-108 HCO3-27
AnGap-14
Calcium-8.6 Phos-3.6 Mg-1.8

IMAGING

CT head ([**2199-2-1**]):
1. No evidence for acute intracranial process.
2. Minimally displaced left nasal bone fracture.
.
CT c-spine ([**2199-2-1**]):
No evidence for acute fracture.
.
CT torso ([**2199-2-1**]):
1. Few tiny bilateral pulmonary nodules, which do not have the
typical appearance of pulmonary contusions but are in the
typical location for pulmonary contusions. Correlation with
smoking history and history of malignancy is recommended. Follow
up CT is recommended in 6 months.
2. Esophageal catheter tip in the stomach but sideport at the
level of the gastroesophageal junction; advancing the tube is
recommended.
3. No acute fracture, pneumothorax, major vascular injury or
other urgent findings.


Brief Hospital Course:
53F presented by ambulance to ED as pedestrian struck by a car.
Given her extreme agitation and combativeness in the ED, she was
intubated.  Following thorough examination and CT imaging of her
head, cervical spine, and torso, she was found to only have a
right frontal scalp contusion with small overlying laceration.

The patient was admitted to the Trauma Surgical ICU under care
of the Acute Care Surgical service for ventilator management and
close monitoring.  She was started on a CIWA scale and her
hematocrit was followed serially, which remained stable.  She
remained hemodynamically stable.

She was weaned from the ventilator and successfully extubated.
Her diet was advanced to a regular diet, which she tolerated
well.  Her foley was removed, and she voided without difficulty.
 A tertiary survey was completed, and no new injuries were
identified.  She was deemed appropriate for discharge on HD#2,
with plans for her to go home with a family member. She was
advised to follow-up with her PCP [**Name Initial (PRE) 176**] 2 weeks of discharge.



Medications on Admission:
Denies

Discharge Medications:
None

Discharge Disposition:
Home

Discharge Diagnosis:
1. Right forehead contusion with laceration
2. Nasal bone fracture, suspected chronic


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
It was a pleasure caring for you during your admission to [**Hospital1 1535**].  You were admitted after being
hit by a motor vehicle.  You had a breathing tube placed
initially that was later able to be removed.  You were found to
have a right forehead laceration.  A nasal bone fracture was
also seen on imaging but appeared to be an old fracture.  After
close monitoring for 24 hours, you are now appropriate for
discharge home.
Please call your doctor or nurse practitioner or return to the
Emergency Department for any of the following:
*You experience new chest pain, pressure, squeezing or
tightness.
*New or worsening cough, shortness of breath, or wheeze.
*If you are vomiting and cannot keep down fluids or your
medications.
*You see blood or dark/black material when you vomit or have a
bowel movement.
*You develop worsening pain that is not relieved by
over-the-counter pain medications.
*You have shaking chills, or fever greater than 101.5 degrees
Fahrenheit or 38 degrees Celsius.
*Any new symptoms that concern you.
-Please resume all regular home medications , unless
specifically advised not to take a particular medication.
-Please get plenty of rest, continue to ambulate several times
per day, and drink adequate amounts of fluids.


Followup Instructions:
Please follow-up with your primary care physician [**Name Initial (PRE) 176**] 2 weeks
of discharge. If you would like to be seen by the Acute Care
Surgery service, you may schedule an appointment by calling
[**Telephone/Fax (1) 600**].
{'Contusion of face, scalp, and neck except eye(s),Concussion with loss of consciousness of unspecified duration,Open wound of scalp, without mention of complication,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Alcohol abuse, unspecified,Anemia, unspecified'}


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: Pedestrian struck

PRESENT ILLNESS: 53F brought to [**Hospital1 18**] ED via ambulance as pedestrian struck by a
car, +EtOH, +LOC.  Upon arrival to [**Hospital1 18**] ED, the patient was
found to be extremetly agitated and combative.  She did not give
a history and did not endorse any particular pain.  She did
complain of shortness of breath.

MEDICAL HISTORY: Alcohol abuse

MEDICATION ON ADMISSION: Denies

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: On admission:

FAMILY HISTORY: Non-contributory

SOCIAL HISTORY: Patient reports to be homeless, living mostly [**Location (un) 84022**]. She has a significant history of alcohol abuse, for
which she has been cared for at [**Hospital1 18**] on multiple occasions for
detox and other related issues. 

### Response:
{'Contusion of face, scalp, and neck except eye(s),Concussion with loss of consciousness of unspecified duration,Open wound of scalp, without mention of complication,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Alcohol abuse, unspecified,Anemia, unspecified'}
