chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Exposure to SARS-CoV-2, Pharyngeal paraesthesia, SARS-CoV-2 test negative, Throat irritation
Clinical narrative: Began experiencing itching and tingly throat on Jan 17th 10 days post vaccination. Began Zyrtec 10mg daily and then increased to twice daily on Tuesday. Also began Benadryl 50mg every 4-6hrs during the day to keep hives contained. By Tuesday 18th I have full body hives. Began prednisone 40mg daily for 5 days. Every evening I have a flare up where I become short of breath and each day the shortness of breath episodes last longer to the point I had to do a nebulizer treatment on the evening of Jan 20. Jan 21 I saw my PCP, received Depo Medrol IM and began askance BID and given an albuterol inhaler PRN. Also instructed to add famotidine to med regimen.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Began experiencing itching and tingly throat on Jan 17th 10 days post vaccination. Began Zyrtec 10mg daily and then increased to twice daily on Tuesday. Also began Benadryl 50mg every 4-6hrs during the day to keep hives contained. By Tuesday 18th I have full body hives. Began prednisone 40mg daily for 5 days. Every evening I have a flare up where I become short of breath and each day the shortness of breath episodes last longer to the point I had to do a nebulizer treatment on the evening of Jan 20. Jan 21 I saw my PCP, received Depo Medrol IM and began askance BID and given an albuterol inhaler PRN. Also instructed to add famotidine to med regimen.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Ear pain, Headache, Tinnitus
Clinical narrative: Headaches all of the time Ear aches just about every day  Tinnitus in left ear  Ringing in the head just about every day
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy bone marrow abnormal, Blood test abnormal, Chronic myeloid leukaemia, White blood cell count increased
Clinical narrative: This form not "user friendly".   I received J&J dose in March.   In November 2021 I had blood test as part of my annual physical.  White blood cell count was high.  More testing - including a bone marrow biopsy have resulted in a diagnosis of chronic myelogenous leukemia.  To be clear I don't think this is a result of the vaccine but I have been reporting via text post vaccine regarding symptoms.   I received a phone call and the caller suggested I complete this form.  I am doing so in an attempt to be helpful!
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Headache, Pain, Pyrexia
Clinical narrative: 104 F. fever, body aches, headaches, and coughing.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given past USE BY date.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Confusional state, Influenza like illness, Myalgia, Tinnitus
Clinical narrative: Ringing in left ear 3 different times. Roaring vibrating sound in right ear one time. Extreme muscle and joint pain. Flu-like body aches. Slight mental confusion.
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Epistaxis, Headache, Oropharyngeal pain
Clinical narrative: 01/15/2022 He woke up in the morning and he was bleeding profusely of his nose so we stuck him in the shower for awhile. He possibly had a headache but unsure. We brought him to the ER and they tested him for Covid and it was positive. He's been on Tylenol and just the honey medicine. He does have a cough and sore throat.
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 01/15/2022 He woke up in the morning and he was bleeding profusely of his nose so we stuck him in the shower for awhile. He possibly had a headache but unsure. We brought him to the ER and they tested him for Covid and it was positive. He's been on Tylenol and just the honey medicine. He does have a cough and sore throat.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Adjustment disorder, Anaemia, Angiogram pulmonary abnormal, Anticoagulant therapy
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Antiplatelet therapy, Aspiration, Back pain, Bacteraemia, Blood culture positive
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Blood lactic acid increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Cerebrovascular accident
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebrovascular disorder, Condition aggravated, Deep vein thrombosis, Dehydration, Drug abuse
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Dry mouth, Dyspnoea, Fracture, Gait disturbance, Gram stain positive
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Hemiparesis, Hepatic enzyme increased, Hypophagia, Hypoxia
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Illness, Malnutrition, Myelopathy, Oesophagogastroduodenoscopy normal, Pain
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Paraparesis, Pneumonia, Pneumonia bacterial, Positive airway pressure therapy, Procalcitonin increased
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Radiotherapy, Respiratory acidosis, SARS-CoV-2 test positive, Sciatica, Sepsis
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Superinfection, Tachycardia, Tachypnoea, Weight decreased, White blood cell count normal
Clinical narrative: PROGRESS NOTE 1/20/2022 This is a   66-year-old male with a complicated PMHx of RLE DVT, spastic paresis 2/2 cervical myelopathy, left pontine infarct in 2018, recurrent stroke in October 21, residual right-sided hemiparesis, recent admission for COVID-pneumonia is being admitted for acute respiratory failure 2/2 COVID, who aspirated on soda at his facility and started to have shortness of breath 1 day prior to admission.  He is being treated for pneumonia, possibly secondary to aspiration.   PLAN Acute respiratory failure w/ hypoxia COVID PNA Probable sepsis Bacteremia Suspected superimposed bacterial PNA Respiratory acidosis Tested positive for covid on 1/11 (previous hospitalization) On arrival to the ER he was hypoxic, tachycardic, tachypenic, given his recent dx of RLE DVT (1/11) there was high concern for a PE and was started on heparin drip. Initially placed on BiPAP, and later was able to transition to CPAP which he tolerated much better. CTA resulted neg for PE but did show extensive b/l PNA. Heparin drip was stopped.  has a slightly elevated procalcitonin, LA 4.4, otherwise normal wbc, afebrile -Started on cefepime and Vanco in ER, continue. -Blood cultures positive for gram-positive cocci.   received 2L IVF in the ER, will hold further given that he is covid + IV Decadron ordered Check CRP 6.4, liver enzymes only mildly elevated, LA elevated on arrival has now resolved.   RLE DVT Diagnosed previous admission, he was not started on anticoagulation due to concern for GI bleed, had a neg EGD.  However in setting of his acute illness and recent covid, stable hgb, continue lovenox 40mg and continue with his  PTA dual anti platelet therapy. Monitor hgb.    Chronic anemia hgb 9.7, likely from dehydration.  Today, back to baseline at 8. Monitor for bleeding Resume PTA protonix   H/o CVAx2 w/ chronic L sided hemiparesis Resume PTA antiplatelet therapy. Neuro status at baseline.   CODE STATUS: Full Code  DVT prophylaxis: lovenox GI prophylaxis: protonix
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered was expired 1/20/2022. Administered 1/21/2022.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Illness, SARS-CoV-2 test positive
Clinical narrative: 1/20/22  I've been sick since Sunday, today's test came back positive. (Telephone message.)
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: Patient was given the adult dosage of the Pfizer vaccine when she was supposed to receive the (PEDS) pediatric dosage. The local county health department does not carry the pediatric dosage of Pfizer. When I viewed her vaccine card since it showed only that she received Pfizer not that she received the pediatric dosage so I assumed that she was over the age of 12. Patient waited in the lobby 15 minutes after receiving the vaccine and no adverse reaction had occurred.
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vaccine administered on 1/20/22 had expired on 1/19/22. There was no temperature excursion
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Dysgeusia
Clinical narrative: Pt experience metallic taste fairly soon after injection and called me 4 hours later concerned about the taste in her mouth.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vaccine administered on 1/20/22 had expired on 1/19/22. There was no temperature excursion
Age: 43.0
Sex: M
Vaccine: FLU4
Symptoms: Abdominal pain, Frequent bowel movements, Haematochezia, Vaccine positive rechallenge
Clinical narrative: Approximately 48 hours after I was administered influenza vaccine, I experienced frequent bowel movements, frequent bloody stools, frequent abdominal pains, etc.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Anion gap increased, Asthma, Blood creatinine increased, Blood gases normal
Clinical narrative: DISCHARGE DIAGNOSES: DKA, mild Type 2 diabetes mellitus on insulin AKI, resolved Hypokalemia, improving. COVID-19 infection, incidental finding HTN Asthma HOSPITAL COURSE: Patient is a 55 y.o. male with a past medical history of Type 2 Diabetes mellitus on insulin, hypertension and asthma who presented to the ED on 1/10/22 for evaluation of hyperglycemia. Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. Also found to be hypokalemic with an AKI likely secondary to lack of PO intake and hyperglycemia. Patient was hydrated with NS + KCL with improvement in his AKI and improvement in his hypokalemia. His Lantus was increased from 23 units q noon to 30 U at noon with improvement in his BG. Stressed the importance of close PCP follow up regarding his diabetes as his HgbA1c came back at >15.9. Patient will be given 5 days of 20 mEq KChloride to take daily with instructions to get a BMP repeat in 2 days when he follows up with his PCP. Patient and his wife understand and are in agreement with this plan. Reviewed COVID quarantine guidelines.    PCP Recommendations: - repeat BMP in 2 days - f/u on COVID recovery, Potassium  - Adjust DM regimen, Lantus increased this admission   HOSPITAL COURSE BY PROBLEM:   DKA, mild, resolved Type 2 diabetes mellitus on insulin Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. PTA Metformin, Glargine 23 U at lunch, Humalog with meals sliding scale. VBG with pH WNL. Lantus increased this admission from 23 U to 30 U daily. HgbA1c came back >15.9.  - continue PTA SSI - Continue 30 U Lantus q noon - counseled on importance of follow up with PCP for DM management given A1c   AKI, resolved Hypokalemia, improving Admit Creat 1.91, baseline Creat ~1.2. K 2.4. Received NS IVF since admission, will switch to NS + KCL. Improved K on day of discharge.  - BMP in 2 days - PCP f/u in 2 days - 5 day rx of Potassium chloride 20 mEq daily given   COVID-19 infection, incidental finding Patient tested positive in ED. Currently asymptomatic and on room air. D-dimer elevated at 11.83. initially placed on 40 MG Lovenox but changed to therapeutic. Remained on room air throughout this admission.  - COVID quarantine guidelines reviewed with patient   HTN PTA Amlodipine 10 MG daily, triamterene/HCTZ 37.5-25 MG daily, hydralazine 25 MG TID, ASA  and Metoprolol 100 MG daily. Bps on the soft side here. Triamterene/HCTZ held in setting of AKI, will resume at d/c - continue Amlodipine, Hydralazine, Metoprolol, ASA - Resume Triamterene/HCTZ in setting of AKI   Asthma PTA fluticasone noted, however, patient states he does not take this.  - hold PTA Fluticasone
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose increased, Blood ketone body, Blood pH normal, Blood potassium, COVID-19
Clinical narrative: DISCHARGE DIAGNOSES: DKA, mild Type 2 diabetes mellitus on insulin AKI, resolved Hypokalemia, improving. COVID-19 infection, incidental finding HTN Asthma HOSPITAL COURSE: Patient is a 55 y.o. male with a past medical history of Type 2 Diabetes mellitus on insulin, hypertension and asthma who presented to the ED on 1/10/22 for evaluation of hyperglycemia. Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. Also found to be hypokalemic with an AKI likely secondary to lack of PO intake and hyperglycemia. Patient was hydrated with NS + KCL with improvement in his AKI and improvement in his hypokalemia. His Lantus was increased from 23 units q noon to 30 U at noon with improvement in his BG. Stressed the importance of close PCP follow up regarding his diabetes as his HgbA1c came back at >15.9. Patient will be given 5 days of 20 mEq KChloride to take daily with instructions to get a BMP repeat in 2 days when he follows up with his PCP. Patient and his wife understand and are in agreement with this plan. Reviewed COVID quarantine guidelines.    PCP Recommendations: - repeat BMP in 2 days - f/u on COVID recovery, Potassium  - Adjust DM regimen, Lantus increased this admission   HOSPITAL COURSE BY PROBLEM:   DKA, mild, resolved Type 2 diabetes mellitus on insulin Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. PTA Metformin, Glargine 23 U at lunch, Humalog with meals sliding scale. VBG with pH WNL. Lantus increased this admission from 23 U to 30 U daily. HgbA1c came back >15.9.  - continue PTA SSI - Continue 30 U Lantus q noon - counseled on importance of follow up with PCP for DM management given A1c   AKI, resolved Hypokalemia, improving Admit Creat 1.91, baseline Creat ~1.2. K 2.4. Received NS IVF since admission, will switch to NS + KCL. Improved K on day of discharge.  - BMP in 2 days - PCP f/u in 2 days - 5 day rx of Potassium chloride 20 mEq daily given   COVID-19 infection, incidental finding Patient tested positive in ED. Currently asymptomatic and on room air. D-dimer elevated at 11.83. initially placed on 40 MG Lovenox but changed to therapeutic. Remained on room air throughout this admission.  - COVID quarantine guidelines reviewed with patient   HTN PTA Amlodipine 10 MG daily, triamterene/HCTZ 37.5-25 MG daily, hydralazine 25 MG TID, ASA  and Metoprolol 100 MG daily. Bps on the soft side here. Triamterene/HCTZ held in setting of AKI, will resume at d/c - continue Amlodipine, Hydralazine, Metoprolol, ASA - Resume Triamterene/HCTZ in setting of AKI   Asthma PTA fluticasone noted, however, patient states he does not take this.  - hold PTA Fluticasone
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Diabetic ketoacidosis, Fibrin D dimer increased, Glycosylated haemoglobin increased, Hyperglycaemia
Clinical narrative: DISCHARGE DIAGNOSES: DKA, mild Type 2 diabetes mellitus on insulin AKI, resolved Hypokalemia, improving. COVID-19 infection, incidental finding HTN Asthma HOSPITAL COURSE: Patient is a 55 y.o. male with a past medical history of Type 2 Diabetes mellitus on insulin, hypertension and asthma who presented to the ED on 1/10/22 for evaluation of hyperglycemia. Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. Also found to be hypokalemic with an AKI likely secondary to lack of PO intake and hyperglycemia. Patient was hydrated with NS + KCL with improvement in his AKI and improvement in his hypokalemia. His Lantus was increased from 23 units q noon to 30 U at noon with improvement in his BG. Stressed the importance of close PCP follow up regarding his diabetes as his HgbA1c came back at >15.9. Patient will be given 5 days of 20 mEq KChloride to take daily with instructions to get a BMP repeat in 2 days when he follows up with his PCP. Patient and his wife understand and are in agreement with this plan. Reviewed COVID quarantine guidelines.    PCP Recommendations: - repeat BMP in 2 days - f/u on COVID recovery, Potassium  - Adjust DM regimen, Lantus increased this admission   HOSPITAL COURSE BY PROBLEM:   DKA, mild, resolved Type 2 diabetes mellitus on insulin Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. PTA Metformin, Glargine 23 U at lunch, Humalog with meals sliding scale. VBG with pH WNL. Lantus increased this admission from 23 U to 30 U daily. HgbA1c came back >15.9.  - continue PTA SSI - Continue 30 U Lantus q noon - counseled on importance of follow up with PCP for DM management given A1c   AKI, resolved Hypokalemia, improving Admit Creat 1.91, baseline Creat ~1.2. K 2.4. Received NS IVF since admission, will switch to NS + KCL. Improved K on day of discharge.  - BMP in 2 days - PCP f/u in 2 days - 5 day rx of Potassium chloride 20 mEq daily given   COVID-19 infection, incidental finding Patient tested positive in ED. Currently asymptomatic and on room air. D-dimer elevated at 11.83. initially placed on 40 MG Lovenox but changed to therapeutic. Remained on room air throughout this admission.  - COVID quarantine guidelines reviewed with patient   HTN PTA Amlodipine 10 MG daily, triamterene/HCTZ 37.5-25 MG daily, hydralazine 25 MG TID, ASA  and Metoprolol 100 MG daily. Bps on the soft side here. Triamterene/HCTZ held in setting of AKI, will resume at d/c - continue Amlodipine, Hydralazine, Metoprolol, ASA - Resume Triamterene/HCTZ in setting of AKI   Asthma PTA fluticasone noted, however, patient states he does not take this.  - hold PTA Fluticasone
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Hypertension, Hypokalaemia, Hypophagia, Insulin-requiring type 2 diabetes mellitus, Metabolic function test
Clinical narrative: DISCHARGE DIAGNOSES: DKA, mild Type 2 diabetes mellitus on insulin AKI, resolved Hypokalemia, improving. COVID-19 infection, incidental finding HTN Asthma HOSPITAL COURSE: Patient is a 55 y.o. male with a past medical history of Type 2 Diabetes mellitus on insulin, hypertension and asthma who presented to the ED on 1/10/22 for evaluation of hyperglycemia. Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. Also found to be hypokalemic with an AKI likely secondary to lack of PO intake and hyperglycemia. Patient was hydrated with NS + KCL with improvement in his AKI and improvement in his hypokalemia. His Lantus was increased from 23 units q noon to 30 U at noon with improvement in his BG. Stressed the importance of close PCP follow up regarding his diabetes as his HgbA1c came back at >15.9. Patient will be given 5 days of 20 mEq KChloride to take daily with instructions to get a BMP repeat in 2 days when he follows up with his PCP. Patient and his wife understand and are in agreement with this plan. Reviewed COVID quarantine guidelines.    PCP Recommendations: - repeat BMP in 2 days - f/u on COVID recovery, Potassium  - Adjust DM regimen, Lantus increased this admission   HOSPITAL COURSE BY PROBLEM:   DKA, mild, resolved Type 2 diabetes mellitus on insulin Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. PTA Metformin, Glargine 23 U at lunch, Humalog with meals sliding scale. VBG with pH WNL. Lantus increased this admission from 23 U to 30 U daily. HgbA1c came back >15.9.  - continue PTA SSI - Continue 30 U Lantus q noon - counseled on importance of follow up with PCP for DM management given A1c   AKI, resolved Hypokalemia, improving Admit Creat 1.91, baseline Creat ~1.2. K 2.4. Received NS IVF since admission, will switch to NS + KCL. Improved K on day of discharge.  - BMP in 2 days - PCP f/u in 2 days - 5 day rx of Potassium chloride 20 mEq daily given   COVID-19 infection, incidental finding Patient tested positive in ED. Currently asymptomatic and on room air. D-dimer elevated at 11.83. initially placed on 40 MG Lovenox but changed to therapeutic. Remained on room air throughout this admission.  - COVID quarantine guidelines reviewed with patient   HTN PTA Amlodipine 10 MG daily, triamterene/HCTZ 37.5-25 MG daily, hydralazine 25 MG TID, ASA  and Metoprolol 100 MG daily. Bps on the soft side here. Triamterene/HCTZ held in setting of AKI, will resume at d/c - continue Amlodipine, Hydralazine, Metoprolol, ASA - Resume Triamterene/HCTZ in setting of AKI   Asthma PTA fluticasone noted, however, patient states he does not take this.  - hold PTA Fluticasone
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: DISCHARGE DIAGNOSES: DKA, mild Type 2 diabetes mellitus on insulin AKI, resolved Hypokalemia, improving. COVID-19 infection, incidental finding HTN Asthma HOSPITAL COURSE: Patient is a 55 y.o. male with a past medical history of Type 2 Diabetes mellitus on insulin, hypertension and asthma who presented to the ED on 1/10/22 for evaluation of hyperglycemia. Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. Also found to be hypokalemic with an AKI likely secondary to lack of PO intake and hyperglycemia. Patient was hydrated with NS + KCL with improvement in his AKI and improvement in his hypokalemia. His Lantus was increased from 23 units q noon to 30 U at noon with improvement in his BG. Stressed the importance of close PCP follow up regarding his diabetes as his HgbA1c came back at >15.9. Patient will be given 5 days of 20 mEq KChloride to take daily with instructions to get a BMP repeat in 2 days when he follows up with his PCP. Patient and his wife understand and are in agreement with this plan. Reviewed COVID quarantine guidelines.    PCP Recommendations: - repeat BMP in 2 days - f/u on COVID recovery, Potassium  - Adjust DM regimen, Lantus increased this admission   HOSPITAL COURSE BY PROBLEM:   DKA, mild, resolved Type 2 diabetes mellitus on insulin Admit BG 376. Corrected anion gap of 18. Beta hydroxybutyrate elevated at 3.09. Likely, hyperglycemia and DKA precipitated by acute COVID infection. PTA Metformin, Glargine 23 U at lunch, Humalog with meals sliding scale. VBG with pH WNL. Lantus increased this admission from 23 U to 30 U daily. HgbA1c came back >15.9.  - continue PTA SSI - Continue 30 U Lantus q noon - counseled on importance of follow up with PCP for DM management given A1c   AKI, resolved Hypokalemia, improving Admit Creat 1.91, baseline Creat ~1.2. K 2.4. Received NS IVF since admission, will switch to NS + KCL. Improved K on day of discharge.  - BMP in 2 days - PCP f/u in 2 days - 5 day rx of Potassium chloride 20 mEq daily given   COVID-19 infection, incidental finding Patient tested positive in ED. Currently asymptomatic and on room air. D-dimer elevated at 11.83. initially placed on 40 MG Lovenox but changed to therapeutic. Remained on room air throughout this admission.  - COVID quarantine guidelines reviewed with patient   HTN PTA Amlodipine 10 MG daily, triamterene/HCTZ 37.5-25 MG daily, hydralazine 25 MG TID, ASA  and Metoprolol 100 MG daily. Bps on the soft side here. Triamterene/HCTZ held in setting of AKI, will resume at d/c - continue Amlodipine, Hydralazine, Metoprolol, ASA - Resume Triamterene/HCTZ in setting of AKI   Asthma PTA fluticasone noted, however, patient states he does not take this.  - hold PTA Fluticasone
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given past USE BY date
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vaccine administered on 1/20/22 had expired on 1/19/22. There was no temperature excursion
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling of eyelid
Clinical narrative: Patient reports swelling of upper left eye lid approximately 1 hour after receiving Pfizer COVID-19 vaccine. Reports that nothing different was done that day other than receiving her vaccine. She has not taken any medication at the time of reporting this. Denies any vision changes or other symptoms besides the upper eye lid swelling.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vaccine administered on 1/20/22 had expired on 1/19/22. There was no temperature excursion.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalization with covid after being fully vaccinated
Age: 70.0
Sex: M
Vaccine: VARZOS, VARZOS
Symptoms: Rash
Clinical narrative: Pt. states that after receiving the 1st dose of Shingrix 01/10/2022, started experiencing symptoms 01/17/2022 of a rash developing on the right side of the body and entire back area. Primary visit 01/20/2022 with recommendations Prednisone.
Age: 70.0
Sex: M
Vaccine: VARZOS, VARZOS
Symptoms: Urticaria
Clinical narrative: Pt. states that after receiving the 1st dose of Shingrix 01/10/2022, started experiencing symptoms 01/17/2022 of a rash developing on the right side of the body and entire back area. Primary visit 01/20/2022 with recommendations Prednisone.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cardiac failure congestive, Condition aggravated, Dyspnoea, Echocardiogram
Clinical narrative: This is a 72y.o. female with PMH hypertension and arthritis with recent left knee replacement on 12/15/2021. She was recently admit at a HCF for CHF exacerbation. Had complete workup, Echo showed EF 40%, received IV lasix during hospitalization and discharged on 1/4. Tested positive on 12/30 for COVID. Again during this stay 1/10. Per patient, she is having worsen dyspnea. Daughter decided to bring her to facility for further veal and txt.  Up on exam this am, patient seems doing well. SOB is better.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Ejection fraction decreased, Knee arthroplasty, SARS-CoV-2 test positive
Clinical narrative: This is a 72y.o. female with PMH hypertension and arthritis with recent left knee replacement on 12/15/2021. She was recently admit at a HCF for CHF exacerbation. Had complete workup, Echo showed EF 40%, received IV lasix during hospitalization and discharged on 1/4. Tested positive on 12/30 for COVID. Again during this stay 1/10. Per patient, she is having worsen dyspnea. Daughter decided to bring her to facility for further veal and txt.  Up on exam this am, patient seems doing well. SOB is better.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Headache, Nausea, Pyrexia
Clinical narrative: Covid positive. Fever, cough, headache, sinus congestion, nausea.  Taking Tylenol, cough medicine
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sinus congestion
Clinical narrative: Covid positive. Fever, cough, headache, sinus congestion, nausea.  Taking Tylenol, cough medicine
Age: 20.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vaccine administered on 1/20/22 had expired on 1/19/22. There was no temperature excursion
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vaccine administered on 1/20/22 had expired on 1/19/22. There was no temperature excursion.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal tenderness, Asthenia, Chills, Decreased appetite, Diarrhoea
Clinical narrative: generalized, significant weakness limiting ambulation, diarrhea for about a week, chills, abdominal tenderness, poor appetite, nausea, decreased p.o. intake, around 10 pound weight loss over past week
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypophagia, Mobility decreased, Nausea, SARS-CoV-2 test, Weight decreased
Clinical narrative: generalized, significant weakness limiting ambulation, diarrhea for about a week, chills, abdominal tenderness, poor appetite, nausea, decreased p.o. intake, around 10 pound weight loss over past week
Age: 24.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest X-ray, SARS-CoV-2 test positive
Clinical narrative: 1/20/22- 25-year-old female who presents to the emergency department after being diagnosed with COVID-19 on 1/20. She reports that she has had symptoms for the last 3 to 4 days. She reports diffuse myalgias, headache, fatigue, intermittent fevers and lightheadedness. She does report her P.O. intake has been decreased. She had COVID-19 1 year ago and had been diagnosed with reactive airway disease, bronchitis after this. She reports that symptoms feel similar. ROS: Constitutional: Fever, chills. Eyes: Does not report eye redness or discharge. HENT: Nasal congestion, sore throat. Respiratory: Cough. Cardiovascular: Does not report chest pain or palpitations. GI:  Does not report abdominal pain, nausea, vomiting or diarrhea. GU: Does not report dysuria or change in urinary habits. Musculoskeletal: Myalgias. Integument: Does not report rash or bruises. Neurologic: Headache. All other systems reviewed and negative
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Respiratory viral panel, SARS-CoV-2 test positive
Clinical narrative: TESTED POSTIVE FOR COVID-19 ON JAN 02, 2022.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Cyanosis, Hypoaesthesia, Paraesthesia
Clinical narrative: Numbness, tingling, and cyanosis in L thumb.