chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test, N-terminal prohormone brain natriuretic peptide increased, Oedema peripheral, Pneumonia, SARS-CoV-2 test positive
Clinical narrative: Covid + on 10/27/2021. Vaccinated with Janssen on 05/25/2021. ED Note: History of Present Illness  65-year-old male with a history of CHF, COPD presents to the ED for difficulty in breathing.  Patient denies ever being intubated in the past.  Patient states that he has been feeling this way for the past few days.  Patient also reports that he has had increased cough as well as decreased appetite.  States that he did get the Covid vaccine.  Patient was most recently discharged here less than a week ago for similar complaint.  Patient has a history of fluid overload and states that he has on a water pill.  Patient does not endorse any chest pain at this time.  Patient denies any nausea, vomiting, fever, chills.    65-year-old male who was recently discharged in the hospital 5 days ago presents ED for shortness of breath.  Per EMS patient was satting in the 80s on his home oxygen.  Patient was immediately placed on nonrebreather.  Upon arrival patient is very tachypneic, speaking short word sentences.  We did give patient a breathing treatment 10 mg albuterol, 1 of Atrovent, 2 of magnesium, 125 Solu-Medrol.  At this time we did also obtain blood cultures, lactic acid, basic labs, chest x-ray, Covid test, proBNP.  On exam patient did have diminished breath sounds.  A bedside ultrasound was performed that did not show any B-lines however patient's lower extremities are very edematous noted abdomen is distended.   X-ray did reveal a left lower lobe pneumonia.  Patient was started on HAP coverage on vancomycin and cefepime.  Patient does not have any leukocytosis.  proBNP is elevated greater than 3000.  Troponins 0.09 however patient creatinine is also elevated.  Not likely NSTEMI.  Patient denies chest pain.  Patient will be admitted to previous provider with ID and pulmonology on consult.   We had received patient's Covid result, it was positive.  This time patient be placed on isolation precautions.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Tachypnoea, Troponin increased, Ultrasound scan
Clinical narrative: Covid + on 10/27/2021. Vaccinated with Janssen on 05/25/2021. ED Note: History of Present Illness  65-year-old male with a history of CHF, COPD presents to the ED for difficulty in breathing.  Patient denies ever being intubated in the past.  Patient states that he has been feeling this way for the past few days.  Patient also reports that he has had increased cough as well as decreased appetite.  States that he did get the Covid vaccine.  Patient was most recently discharged here less than a week ago for similar complaint.  Patient has a history of fluid overload and states that he has on a water pill.  Patient does not endorse any chest pain at this time.  Patient denies any nausea, vomiting, fever, chills.    65-year-old male who was recently discharged in the hospital 5 days ago presents ED for shortness of breath.  Per EMS patient was satting in the 80s on his home oxygen.  Patient was immediately placed on nonrebreather.  Upon arrival patient is very tachypneic, speaking short word sentences.  We did give patient a breathing treatment 10 mg albuterol, 1 of Atrovent, 2 of magnesium, 125 Solu-Medrol.  At this time we did also obtain blood cultures, lactic acid, basic labs, chest x-ray, Covid test, proBNP.  On exam patient did have diminished breath sounds.  A bedside ultrasound was performed that did not show any B-lines however patient's lower extremities are very edematous noted abdomen is distended.   X-ray did reveal a left lower lobe pneumonia.  Patient was started on HAP coverage on vancomycin and cefepime.  Patient does not have any leukocytosis.  proBNP is elevated greater than 3000.  Troponins 0.09 however patient creatinine is also elevated.  Not likely NSTEMI.  Patient denies chest pain.  Patient will be admitted to previous provider with ID and pulmonology on consult.   We had received patient's Covid result, it was positive.  This time patient be placed on isolation precautions.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Urticaria
Clinical narrative: I started to itch on the afternoon of 10/25/2021 at approximately 1pm.  It started in one area then started in another until I was covered with itching including the inside of my ear canal, the bottoms of my feet, my palms, the top of my head, neck, chest, legs backside everywhere.  All the on call locations were booked and had nowhere to go.  I went to pharmacy and a pharmacist pointed me to a box of Benadryl.  I tried it and it did tamp down the itch within 45 minutes then I was able to sleep.  I went to the doctor and they saw what I looked like.  They said it looked like I was whipped with a belt..  I had huge welts on my legs, back, chest, and it itched like crazy. and it still does as of this writing.  They put me on Prednisone and I just took my second dose and I'm not seeing much difference.  I drive a school bus so I cannot take the Benadryl during the day but I do at night when I'm home.  Currently I still itch all over including my forehead, face, neck back the bottoms of my feet, everywhere.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy, Cardiac imaging procedure, Cerebrovascular accident, Ear discomfort, Facial paralysis
Clinical narrative: After the vaccine I had like a stroke and the stroke did not progress because I went to emergency room. Diagnostic: Bell's palsy. Half right of my face was paralyzed and the right eye cries. there is no movement on that side of the face, the nerves are paralyzed. My neck hurts a lot (near the right ear) my ear hurts a lot and I feel like air in my ear. Doctor gave me medicine (asteroids).
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Lacrimation increased, Metabolic function test, Neck pain, SARS-CoV-2 test negative, Scan brain
Clinical narrative: After the vaccine I had like a stroke and the stroke did not progress because I went to emergency room. Diagnostic: Bell's palsy. Half right of my face was paralyzed and the right eye cries. there is no movement on that side of the face, the nerves are paralyzed. My neck hurts a lot (near the right ear) my ear hurts a lot and I feel like air in my ear. Doctor gave me medicine (asteroids).
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Lip ulceration, Nodule, Oral disorder, Skin lesion
Clinical narrative: The day after treatment patient developed a nodule under left nostril, which persisted for 3-4 weeks prior to "moving down" onto lip and ulcerating. Ulcer has persisted for two months.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered, Incorrect dose administered
Clinical narrative: Patient was given .5ml instead of the recommended .25ml of moderna
Age: 1.08
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain upper, Anxiety, Cardiac stress test normal, Chest discomfort, Chest pain
Clinical narrative: Symptoms: Chest Tightness/Pain, Shortness of Breath, Raspy Voice, Elevated Heart Beat, Elevated Blood Pressure, Stomach Pain, Muscle Cramps, Joint Stiffness, Headache, Dizzy, Anxiety, Tired, Overwhelming Feeling of being Unwell. Treatment: Admitted to Hospital Emergency Room 10/21/2021 @ 10:00 AM, Released 10/23/2021 @ 12:19 PM. Treatment: STOP Amlodipine-Atorvastatin 10-40, START Amlodipine Besylate 10mg, START Atorvastatin Calcium 80mg, START Pantoprazole Sodium 40mg X2.
Age: 1.08
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram abdomen normal, Dizziness, Dysphonia, Dyspnoea, Echocardiogram normal
Clinical narrative: Symptoms: Chest Tightness/Pain, Shortness of Breath, Raspy Voice, Elevated Heart Beat, Elevated Blood Pressure, Stomach Pain, Muscle Cramps, Joint Stiffness, Headache, Dizzy, Anxiety, Tired, Overwhelming Feeling of being Unwell. Treatment: Admitted to Hospital Emergency Room 10/21/2021 @ 10:00 AM, Released 10/23/2021 @ 12:19 PM. Treatment: STOP Amlodipine-Atorvastatin 10-40, START Amlodipine Besylate 10mg, START Atorvastatin Calcium 80mg, START Pantoprazole Sodium 40mg X2.
Age: 1.08
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Headache, Heart rate increased, Hypertension, Joint stiffness
Clinical narrative: Symptoms: Chest Tightness/Pain, Shortness of Breath, Raspy Voice, Elevated Heart Beat, Elevated Blood Pressure, Stomach Pain, Muscle Cramps, Joint Stiffness, Headache, Dizzy, Anxiety, Tired, Overwhelming Feeling of being Unwell. Treatment: Admitted to Hospital Emergency Room 10/21/2021 @ 10:00 AM, Released 10/23/2021 @ 12:19 PM. Treatment: STOP Amlodipine-Atorvastatin 10-40, START Amlodipine Besylate 10mg, START Atorvastatin Calcium 80mg, START Pantoprazole Sodium 40mg X2.
Age: 1.08
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Malaise, Muscle spasms, Myocardial necrosis marker normal, Scan with contrast normal
Clinical narrative: Symptoms: Chest Tightness/Pain, Shortness of Breath, Raspy Voice, Elevated Heart Beat, Elevated Blood Pressure, Stomach Pain, Muscle Cramps, Joint Stiffness, Headache, Dizzy, Anxiety, Tired, Overwhelming Feeling of being Unwell. Treatment: Admitted to Hospital Emergency Room 10/21/2021 @ 10:00 AM, Released 10/23/2021 @ 12:19 PM. Treatment: STOP Amlodipine-Atorvastatin 10-40, START Amlodipine Besylate 10mg, START Atorvastatin Calcium 80mg, START Pantoprazole Sodium 40mg X2.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Influenza like illness, Urticaria
Clinical narrative: Within 2 hour, Severe upper body hives,urticaria, took bendryl 50 mg twice in next 24 hours.  Day two, felt like I had the flu, temp of approx 100 degrees for about  8 hours.  Short episode of diarrhea.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: Queasiness, feeling  of nausea for 4 hours
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Vertigo positional
Clinical narrative: Benign paroxysmal positional vertigo, bilateral (vertigo when laying in bed, lasting +/- 30 seconds, occuring a few times per week, continuing for several weeks)
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Encephalitis, Intensive care, Nervous system disorder
Clinical narrative: Acute Cerebellitis Patient is currently critically ill, admitted to the Hospital with severe life-threatening neurologic failure due to acute cerebellitis of unknown etiology.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Injection site erythema, Injection site induration, Injection site pain
Clinical narrative: Day 1 - fine until evening then arm pain at injection site (upper left arm) and all over headache set in Day 2 - Full body chills, pins and needles all over,  headache and seem pain + hardening at injection site. By 7pm dull pain under left eye in sinus duct area. Day 3 - arm pain, hardening  + reddening at injection site and facial swelling under left eye along with pressure, hardening and dull pain.  * reported to Covid nurse line * icing left side of face and took a Benadryl
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Ocular discomfort, Pain, Pain in extremity, Paraesthesia, Sinus pain
Clinical narrative: Day 1 - fine until evening then arm pain at injection site (upper left arm) and all over headache set in Day 2 - Full body chills, pins and needles all over,  headache and seem pain + hardening at injection site. By 7pm dull pain under left eye in sinus duct area. Day 3 - arm pain, hardening  + reddening at injection site and facial swelling under left eye along with pressure, hardening and dull pain.  * reported to Covid nurse line * icing left side of face and took a Benadryl
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling face
Clinical narrative: Day 1 - fine until evening then arm pain at injection site (upper left arm) and all over headache set in Day 2 - Full body chills, pins and needles all over,  headache and seem pain + hardening at injection site. By 7pm dull pain under left eye in sinus duct area. Day 3 - arm pain, hardening  + reddening at injection site and facial swelling under left eye along with pressure, hardening and dull pain.  * reported to Covid nurse line * icing left side of face and took a Benadryl
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Rash
Clinical narrative: Fever and rash, Tylenol was given
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Balance disorder, Chest injury, Dizziness, Face injury, Fall
Clinical narrative: The day after receiving the vaccine, I continued to feel tired, dizzy, with pain on injection site and overall pain, That same day at  night I felt severe dizziness and sensation of room spinning. When I stood up, I lost my balance and fell down on floor which resulted in laceration to my chin, broken tooth and injury to my right jaw and chest.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Injection site pain, Pain, Skin laceration, Suture insertion
Clinical narrative: The day after receiving the vaccine, I continued to feel tired, dizzy, with pain on injection site and overall pain, That same day at  night I felt severe dizziness and sensation of room spinning. When I stood up, I lost my balance and fell down on floor which resulted in laceration to my chin, broken tooth and injury to my right jaw and chest.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Tooth fracture, Tooth injury, Vertigo
Clinical narrative: The day after receiving the vaccine, I continued to feel tired, dizzy, with pain on injection site and overall pain, That same day at  night I felt severe dizziness and sensation of room spinning. When I stood up, I lost my balance and fell down on floor which resulted in laceration to my chin, broken tooth and injury to my right jaw and chest.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dizziness, Fall, Injury, Pain in extremity, Tooth fracture
Clinical narrative: The day after receiving the vaccine, I continued to feel tired, dizzy, with pain on injection site and overall pain, That same day at  night I felt severe dizziness and sensation of room spinning. When I stood up, I lost my balance and fell down on floor which resulted in laceration to my chin, broken tooth and injury to my right jaw and chest.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Tooth injury
Clinical narrative: The day after receiving the vaccine, I continued to feel tired, dizzy, with pain on injection site and overall pain, That same day at  night I felt severe dizziness and sensation of room spinning. When I stood up, I lost my balance and fell down on floor which resulted in laceration to my chin, broken tooth and injury to my right jaw and chest.
Age: 13.0
Sex: M
Vaccine: HEPA, HPV9, IPV, MMRV, MNQ, TDAP
Symptoms: Dizziness, Pallor, Syncope
Clinical narrative: After vaccines were administered, the child stood up abruptly and swayed.  The nurse asked if he felt all right and he said yes, and almost immediately fainted.  He was caught before he hit the floor.  Ammonia salts were utilized and he revived immediately and tried to stand.  Nurse and MA kept the child in a prone position for approximately ten minutes. When asked, he said he ate a little yogurt for breakfast.  Mom stayed on her phone.  When helped to a sitting position in a chair, the child lost color in his face again and dropped something from his hand.  MA and nurse wheeled the child to a sofa in an employee break room.  When given water, he drank it very thirstily and stated he had not had anything to drink all day.  Mom gave child a juice box which he drank completely.  He stayed on the sofa for approximately 20 minutes.  He had some shivering.  As he would drink fluids, he would regain color in his lips and face.  After a few minutes post-hydration, his color would pale again.  Mom remained on her phone, while stating to clinic staff that "he got too many shots."  (The child, a recent immigrant, did not have requisite vaccinations to enroll in school.  He received the five necessary vaccination for enrollment, and Mother requested that HPV be given also.)  Mother was educated about eating and drinking before the next visit and if the child needed further medical attention, to take the child to his doctor or an Urgent Care near their home.  The vaccines were administered at 10;40 and the family departed the clinic at 11:20.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Paraesthesia, Spinal pain
Clinical narrative: Fatigue-mild headache 10/25 & 10/26 Spine pain 10/27 Pins and needles left arm on and off 10/28
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient was given .5ml instead of the recommended dose of .25ml of moderna
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dyspnoea, Headache, Pruritus, Pyrexia
Clinical narrative: Horrible itching clawing my face and body, trouble breathing, fever, headache, diarrhea, tongue felt swollen
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Swollen tongue
Clinical narrative: Horrible itching clawing my face and body, trouble breathing, fever, headache, diarrhea, tongue felt swollen
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Vertigo
Clinical narrative: About 24 hours after my second vaccination on April 23, 2021, I started to experience dizziness, which felt like spells of vertigo, too. Since then, I've had very short spells of vertigo anytime I am laying down or getting up.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Heart rate increased
Clinical narrative: Rapid heart rate and fatigue.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cardiac monitoring, Cardiac telemetry, Drug screen, Drug screen negative, Echocardiogram
Clinical narrative: The day after vaccination, patient syncopized at home. was found down by son.  had respiratory depression, was given narcan, IV fluids, and supplemental oxygen, and slowly became responsive. Urine drug screen negative for opioids.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electrocardiogram, Fall, Full blood count, Laboratory test, Magnetic resonance imaging head
Clinical narrative: The day after vaccination, patient syncopized at home. was found down by son.  had respiratory depression, was given narcan, IV fluids, and supplemental oxygen, and slowly became responsive. Urine drug screen negative for opioids.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Metabolic function test, Respiratory depression, Syncope, Troponin
Clinical narrative: The day after vaccination, patient syncopized at home. was found down by son.  had respiratory depression, was given narcan, IV fluids, and supplemental oxygen, and slowly became responsive. Urine drug screen negative for opioids.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Amnesia, Blood test normal, Loss of consciousness
Clinical narrative: The day after vaccination, patient syncopized at home. was found down by son.  had respiratory depression, was given narcan, IV fluids, and supplemental oxygen, and slowly became responsive. Urine drug screen negative for opioids.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cardiac monitoring, Cardiac telemetry, Drug screen, Drug screen negative, Echocardiogram
Clinical narrative: Had vaccine, felt fine, went home, later in evening found unconscious on toilet by son. o2 sat is 87% and sbp in the 80s. improved w/ ivf and the pt does not remember the event.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electrocardiogram, Fall, Full blood count, Laboratory test, Magnetic resonance imaging head
Clinical narrative: Had vaccine, felt fine, went home, later in evening found unconscious on toilet by son. o2 sat is 87% and sbp in the 80s. improved w/ ivf and the pt does not remember the event.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Metabolic function test, Respiratory depression, Syncope, Troponin
Clinical narrative: Had vaccine, felt fine, went home, later in evening found unconscious on toilet by son. o2 sat is 87% and sbp in the 80s. improved w/ ivf and the pt does not remember the event.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Amnesia, Blood test normal, Loss of consciousness
Clinical narrative: Had vaccine, felt fine, went home, later in evening found unconscious on toilet by son. o2 sat is 87% and sbp in the 80s. improved w/ ivf and the pt does not remember the event.
Age: 39.0
Sex: F
Vaccine: TDAP
Symptoms: Fatigue, Migraine, Mobility decreased, Pain in extremity, Vision blurred
Clinical narrative: migraine , blurred vision, extreme fatigue, arm pain for days could not move arm at all
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administration error, expired vaccine given.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Patient requested first dose of Moderna vaccine.  Dose was drawn from a vial left-over from the previous afternoon's use and not discarded at the end of the day.  Discovered after the dose was administered.  Moderna contacted on vaccine viability of dose at room temperature >12 hours but less than 24 hours.  Dose is viable and does not need to be repeated.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary normal, Areflexia, Arthralgia, Asthenia, Back pain
Clinical narrative: Progressive bilateral lower extremity weakness and numbness/tingling in his hands that began 6 hours post-COVID-19 vaccination. He had 3 visits to the emergency room on 5/31, 6/2, and 6/4. On 6/4 he was hospitalized for suspected Guillain-barre syndrome and treated with IVIG with reported improvement.   5/31: ED visit for generalized weakness, urinary frequency, itching, joint soreness, fever. Normal CXR, CTPA, ekg. Elevated CPK and d-dimer. Treated with decadron 8mg IVP and po x 5 days and zpack. 6/2: ED visit for weakness/numbess in BLE.  No sig findings on CXR, CT Head, EKG. Prednisone 60mg po, naproxen 500mg po, Kcl 25mg po. Discharged with Medrol 4mg dose pack and naproxen.  6/4: ED visit for same complaint and back pain. No acute findings on CT L-spine. Transferred to a different hospital for neuro eval for suspected GBS Alternative Hospital course: Neuro A/P ? Acute to subacute onset of progressive and ascending LE weakness with areflexia. Main differential includes acute demyelinating polyneuropathy vs viral neuropathy including West Nile. LP and start IVIG. 6/7: Neuro progress note ? Pt with suspected acute demyelinating polyneuropathy. BLE weakness and ambulation improving. Unable to tolerate MRI.  CSF results: traumatic tap, normal OP/glucose. Elevated WBC and protein. West Nile IgG+, IgM negative.  Discharged to inpatient rehab on 6/10 and discharged home 6/24.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatine phosphokinase increased, Blood immunoglobulin G normal, Blood immunoglobulin M normal, CSF glucose normal, CSF protein increased
Clinical narrative: Progressive bilateral lower extremity weakness and numbness/tingling in his hands that began 6 hours post-COVID-19 vaccination. He had 3 visits to the emergency room on 5/31, 6/2, and 6/4. On 6/4 he was hospitalized for suspected Guillain-barre syndrome and treated with IVIG with reported improvement.   5/31: ED visit for generalized weakness, urinary frequency, itching, joint soreness, fever. Normal CXR, CTPA, ekg. Elevated CPK and d-dimer. Treated with decadron 8mg IVP and po x 5 days and zpack. 6/2: ED visit for weakness/numbess in BLE.  No sig findings on CXR, CT Head, EKG. Prednisone 60mg po, naproxen 500mg po, Kcl 25mg po. Discharged with Medrol 4mg dose pack and naproxen.  6/4: ED visit for same complaint and back pain. No acute findings on CT L-spine. Transferred to a different hospital for neuro eval for suspected GBS Alternative Hospital course: Neuro A/P ? Acute to subacute onset of progressive and ascending LE weakness with areflexia. Main differential includes acute demyelinating polyneuropathy vs viral neuropathy including West Nile. LP and start IVIG. 6/7: Neuro progress note ? Pt with suspected acute demyelinating polyneuropathy. BLE weakness and ambulation improving. Unable to tolerate MRI.  CSF results: traumatic tap, normal OP/glucose. Elevated WBC and protein. West Nile IgG+, IgM negative.  Discharged to inpatient rehab on 6/10 and discharged home 6/24.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: CSF test, CSF white blood cell count increased, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram spine
Clinical narrative: Progressive bilateral lower extremity weakness and numbness/tingling in his hands that began 6 hours post-COVID-19 vaccination. He had 3 visits to the emergency room on 5/31, 6/2, and 6/4. On 6/4 he was hospitalized for suspected Guillain-barre syndrome and treated with IVIG with reported improvement.   5/31: ED visit for generalized weakness, urinary frequency, itching, joint soreness, fever. Normal CXR, CTPA, ekg. Elevated CPK and d-dimer. Treated with decadron 8mg IVP and po x 5 days and zpack. 6/2: ED visit for weakness/numbess in BLE.  No sig findings on CXR, CT Head, EKG. Prednisone 60mg po, naproxen 500mg po, Kcl 25mg po. Discharged with Medrol 4mg dose pack and naproxen.  6/4: ED visit for same complaint and back pain. No acute findings on CT L-spine. Transferred to a different hospital for neuro eval for suspected GBS Alternative Hospital course: Neuro A/P ? Acute to subacute onset of progressive and ascending LE weakness with areflexia. Main differential includes acute demyelinating polyneuropathy vs viral neuropathy including West Nile. LP and start IVIG. 6/7: Neuro progress note ? Pt with suspected acute demyelinating polyneuropathy. BLE weakness and ambulation improving. Unable to tolerate MRI.  CSF results: traumatic tap, normal OP/glucose. Elevated WBC and protein. West Nile IgG+, IgM negative.  Discharged to inpatient rehab on 6/10 and discharged home 6/24.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Demyelinating polyneuropathy, Electrocardiogram normal, Fibrin D dimer increased, Guillain-Barre syndrome, Hypoaesthesia
Clinical narrative: Progressive bilateral lower extremity weakness and numbness/tingling in his hands that began 6 hours post-COVID-19 vaccination. He had 3 visits to the emergency room on 5/31, 6/2, and 6/4. On 6/4 he was hospitalized for suspected Guillain-barre syndrome and treated with IVIG with reported improvement.   5/31: ED visit for generalized weakness, urinary frequency, itching, joint soreness, fever. Normal CXR, CTPA, ekg. Elevated CPK and d-dimer. Treated with decadron 8mg IVP and po x 5 days and zpack. 6/2: ED visit for weakness/numbess in BLE.  No sig findings on CXR, CT Head, EKG. Prednisone 60mg po, naproxen 500mg po, Kcl 25mg po. Discharged with Medrol 4mg dose pack and naproxen.  6/4: ED visit for same complaint and back pain. No acute findings on CT L-spine. Transferred to a different hospital for neuro eval for suspected GBS Alternative Hospital course: Neuro A/P ? Acute to subacute onset of progressive and ascending LE weakness with areflexia. Main differential includes acute demyelinating polyneuropathy vs viral neuropathy including West Nile. LP and start IVIG. 6/7: Neuro progress note ? Pt with suspected acute demyelinating polyneuropathy. BLE weakness and ambulation improving. Unable to tolerate MRI.  CSF results: traumatic tap, normal OP/glucose. Elevated WBC and protein. West Nile IgG+, IgM negative.  Discharged to inpatient rehab on 6/10 and discharged home 6/24.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Immunoglobulin therapy, Lumbar puncture, Muscular weakness, Neurological examination, Neuropathy peripheral
Clinical narrative: Progressive bilateral lower extremity weakness and numbness/tingling in his hands that began 6 hours post-COVID-19 vaccination. He had 3 visits to the emergency room on 5/31, 6/2, and 6/4. On 6/4 he was hospitalized for suspected Guillain-barre syndrome and treated with IVIG with reported improvement.   5/31: ED visit for generalized weakness, urinary frequency, itching, joint soreness, fever. Normal CXR, CTPA, ekg. Elevated CPK and d-dimer. Treated with decadron 8mg IVP and po x 5 days and zpack. 6/2: ED visit for weakness/numbess in BLE.  No sig findings on CXR, CT Head, EKG. Prednisone 60mg po, naproxen 500mg po, Kcl 25mg po. Discharged with Medrol 4mg dose pack and naproxen.  6/4: ED visit for same complaint and back pain. No acute findings on CT L-spine. Transferred to a different hospital for neuro eval for suspected GBS Alternative Hospital course: Neuro A/P ? Acute to subacute onset of progressive and ascending LE weakness with areflexia. Main differential includes acute demyelinating polyneuropathy vs viral neuropathy including West Nile. LP and start IVIG. 6/7: Neuro progress note ? Pt with suspected acute demyelinating polyneuropathy. BLE weakness and ambulation improving. Unable to tolerate MRI.  CSF results: traumatic tap, normal OP/glucose. Elevated WBC and protein. West Nile IgG+, IgM negative.  Discharged to inpatient rehab on 6/10 and discharged home 6/24.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Paraesthesia, Pollakiuria, Pruritus, Pyrexia, Traumatic lumbar puncture
Clinical narrative: Progressive bilateral lower extremity weakness and numbness/tingling in his hands that began 6 hours post-COVID-19 vaccination. He had 3 visits to the emergency room on 5/31, 6/2, and 6/4. On 6/4 he was hospitalized for suspected Guillain-barre syndrome and treated with IVIG with reported improvement.   5/31: ED visit for generalized weakness, urinary frequency, itching, joint soreness, fever. Normal CXR, CTPA, ekg. Elevated CPK and d-dimer. Treated with decadron 8mg IVP and po x 5 days and zpack. 6/2: ED visit for weakness/numbess in BLE.  No sig findings on CXR, CT Head, EKG. Prednisone 60mg po, naproxen 500mg po, Kcl 25mg po. Discharged with Medrol 4mg dose pack and naproxen.  6/4: ED visit for same complaint and back pain. No acute findings on CT L-spine. Transferred to a different hospital for neuro eval for suspected GBS Alternative Hospital course: Neuro A/P ? Acute to subacute onset of progressive and ascending LE weakness with areflexia. Main differential includes acute demyelinating polyneuropathy vs viral neuropathy including West Nile. LP and start IVIG. 6/7: Neuro progress note ? Pt with suspected acute demyelinating polyneuropathy. BLE weakness and ambulation improving. Unable to tolerate MRI.  CSF results: traumatic tap, normal OP/glucose. Elevated WBC and protein. West Nile IgG+, IgM negative.  Discharged to inpatient rehab on 6/10 and discharged home 6/24.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: West Nile virus test negative
Clinical narrative: Progressive bilateral lower extremity weakness and numbness/tingling in his hands that began 6 hours post-COVID-19 vaccination. He had 3 visits to the emergency room on 5/31, 6/2, and 6/4. On 6/4 he was hospitalized for suspected Guillain-barre syndrome and treated with IVIG with reported improvement.   5/31: ED visit for generalized weakness, urinary frequency, itching, joint soreness, fever. Normal CXR, CTPA, ekg. Elevated CPK and d-dimer. Treated with decadron 8mg IVP and po x 5 days and zpack. 6/2: ED visit for weakness/numbess in BLE.  No sig findings on CXR, CT Head, EKG. Prednisone 60mg po, naproxen 500mg po, Kcl 25mg po. Discharged with Medrol 4mg dose pack and naproxen.  6/4: ED visit for same complaint and back pain. No acute findings on CT L-spine. Transferred to a different hospital for neuro eval for suspected GBS Alternative Hospital course: Neuro A/P ? Acute to subacute onset of progressive and ascending LE weakness with areflexia. Main differential includes acute demyelinating polyneuropathy vs viral neuropathy including West Nile. LP and start IVIG. 6/7: Neuro progress note ? Pt with suspected acute demyelinating polyneuropathy. BLE weakness and ambulation improving. Unable to tolerate MRI.  CSF results: traumatic tap, normal OP/glucose. Elevated WBC and protein. West Nile IgG+, IgM negative.  Discharged to inpatient rehab on 6/10 and discharged home 6/24.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Incorrect dose administered
Clinical narrative: Patient was given .5ml  instead of the .25ml  of moderna
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Axillary pain, Lymph node pain, Pain, Pyrexia
Clinical narrative: Severe underarm pain on right side.  Appears to be pain in a lymph node, continuing today for a second day.  Continuous pain and pain to the touch.  I also had a low-grade fever yesterday and joint pain.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Tenderness
Clinical narrative: Severe underarm pain on right side.  Appears to be pain in a lymph node, continuing today for a second day.  Continuous pain and pain to the touch.  I also had a low-grade fever yesterday and joint pain.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Incomplete course of vaccination
Clinical narrative: partially vaccinated-covid related death
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy, Nausea, Pyrexia
Clinical narrative: 8 hours of 101 degree fever, Swollen lymph node on side of injection, nausea
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Bundle branch block right, Chills, Electrocardiogram abnormal, Gout
Clinical narrative: experienced rapid heart beat, severe chills and muscle aches, and fever with no response from tylenol. Then, went to ER, had fever of 102.7 (after taking tylenol), tachycardia, and thrombocytopenia.  Was discharged home after 2 liters of IV fluid and tylenol, and followed up with PCP 10 days later with repeated lab work that showed thrombocytopenia had resolved. EKG normalized. tachycardia resolved.  5 weeks later had a new onset of pain and swelling to right ankle- no injuries. Diagnosed with gout on 10/19/21.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate increased, Joint swelling, Myalgia, Myocardial infarction, Platelet count decreased
Clinical narrative: experienced rapid heart beat, severe chills and muscle aches, and fever with no response from tylenol. Then, went to ER, had fever of 102.7 (after taking tylenol), tachycardia, and thrombocytopenia.  Was discharged home after 2 liters of IV fluid and tylenol, and followed up with PCP 10 days later with repeated lab work that showed thrombocytopenia had resolved. EKG normalized. tachycardia resolved.  5 weeks later had a new onset of pain and swelling to right ankle- no injuries. Diagnosed with gout on 10/19/21.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Sinus tachycardia, Tachycardia, Thrombocytopenia
Clinical narrative: experienced rapid heart beat, severe chills and muscle aches, and fever with no response from tylenol. Then, went to ER, had fever of 102.7 (after taking tylenol), tachycardia, and thrombocytopenia.  Was discharged home after 2 liters of IV fluid and tylenol, and followed up with PCP 10 days later with repeated lab work that showed thrombocytopenia had resolved. EKG normalized. tachycardia resolved.  5 weeks later had a new onset of pain and swelling to right ankle- no injuries. Diagnosed with gout on 10/19/21.
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Shortness of Breath and cough
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatine phosphokinase, Blood gases, Blood lactate dehydrogenase abnormal, Blood lactic acid
Clinical narrative: 74yr old female who presents to ED with complaints of not feeling well.  Patient states she woke up yesterday morning with a headache and body aches.  Patient states she has had a fever and an increase in her cough.  Patient states she has been coughing up thick, yellow phlegm.  States she feels short of breath with exertion. Patient on O2 via NC at 4L, states this is her normal at home. Patient states she has diarrhea but states this is not new for her.  Patient states she has had the dry heaves.  Patient states they had a family gathering over the weekend.  Patient states she has been vaccinated for covid.  Pneumonia due to COVID-19 virus  AIRBORNE PRECAUTIONS    CONTACT PRECAUTIONS   INFECTION CONTROL REFERRAL   CULTURE, BLOOD   FERRITIN   LDH TOTAL   CK   cefTRIAXone (ROCEPHIN) in D-2.22% 50 mL IV piggyback (DUPLEX) (premix) 2,000 mg 2. Cough  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   LACTIC ACID   ESR   BLOOD GASES VENOUS   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE - 3. Nausea  ondansetron (ZOFRAN) injection solution 4 mg   ondansetron (ZOFRAN) injection solution 4 mg 4. Other headache syndrome  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   ondansetron (ZOFRAN) injection solution 4 mg   ketorolac (TORADOL) intravenous injection 15 mg 5. Shortness of breath  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   D-DIMER QUANTITATIVE   TROPONIN I   EKG   LACTIC ACID   ESR   CULTURE, BLOOD   BRAIN NATRIURETIC PEPTIDE   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE -   CTA CHEST   TROPONIN I 6. PAH (pulmonary arterial hypertension) with portal hypertension  BLOOD GASES VENOUS 7. Elevated troponin level    8. Positive D dimer  CTA CHEST 9. Elevated serum lactate dehydrogenase (LDH)    10. AKI (acute kidney injury)  URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE   sodium chloride 0.9% (bolus) IV solution 250 mL 11. Liver cirrhosis secondary to NASH  PROTIME/INR   PTT     ASSESSMENT/PLAN/DECISION MAKING: -Transferred to another healthcare facility.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide, C-reactive protein, COVID-19 pneumonia, Chest X-ray, Computerised tomogram thorax
Clinical narrative: 74yr old female who presents to ED with complaints of not feeling well.  Patient states she woke up yesterday morning with a headache and body aches.  Patient states she has had a fever and an increase in her cough.  Patient states she has been coughing up thick, yellow phlegm.  States she feels short of breath with exertion. Patient on O2 via NC at 4L, states this is her normal at home. Patient states she has diarrhea but states this is not new for her.  Patient states she has had the dry heaves.  Patient states they had a family gathering over the weekend.  Patient states she has been vaccinated for covid.  Pneumonia due to COVID-19 virus  AIRBORNE PRECAUTIONS    CONTACT PRECAUTIONS   INFECTION CONTROL REFERRAL   CULTURE, BLOOD   FERRITIN   LDH TOTAL   CK   cefTRIAXone (ROCEPHIN) in D-2.22% 50 mL IV piggyback (DUPLEX) (premix) 2,000 mg 2. Cough  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   LACTIC ACID   ESR   BLOOD GASES VENOUS   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE - 3. Nausea  ondansetron (ZOFRAN) injection solution 4 mg   ondansetron (ZOFRAN) injection solution 4 mg 4. Other headache syndrome  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   ondansetron (ZOFRAN) injection solution 4 mg   ketorolac (TORADOL) intravenous injection 15 mg 5. Shortness of breath  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   D-DIMER QUANTITATIVE   TROPONIN I   EKG   LACTIC ACID   ESR   CULTURE, BLOOD   BRAIN NATRIURETIC PEPTIDE   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE -   CTA CHEST   TROPONIN I 6. PAH (pulmonary arterial hypertension) with portal hypertension  BLOOD GASES VENOUS 7. Elevated troponin level    8. Positive D dimer  CTA CHEST 9. Elevated serum lactate dehydrogenase (LDH)    10. AKI (acute kidney injury)  URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE   sodium chloride 0.9% (bolus) IV solution 250 mL 11. Liver cirrhosis secondary to NASH  PROTIME/INR   PTT     ASSESSMENT/PLAN/DECISION MAKING: -Transferred to another healthcare facility.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Culture, Diarrhoea, Differential white blood cell count, Dyspnoea exertional
Clinical narrative: 74yr old female who presents to ED with complaints of not feeling well.  Patient states she woke up yesterday morning with a headache and body aches.  Patient states she has had a fever and an increase in her cough.  Patient states she has been coughing up thick, yellow phlegm.  States she feels short of breath with exertion. Patient on O2 via NC at 4L, states this is her normal at home. Patient states she has diarrhea but states this is not new for her.  Patient states she has had the dry heaves.  Patient states they had a family gathering over the weekend.  Patient states she has been vaccinated for covid.  Pneumonia due to COVID-19 virus  AIRBORNE PRECAUTIONS    CONTACT PRECAUTIONS   INFECTION CONTROL REFERRAL   CULTURE, BLOOD   FERRITIN   LDH TOTAL   CK   cefTRIAXone (ROCEPHIN) in D-2.22% 50 mL IV piggyback (DUPLEX) (premix) 2,000 mg 2. Cough  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   LACTIC ACID   ESR   BLOOD GASES VENOUS   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE - 3. Nausea  ondansetron (ZOFRAN) injection solution 4 mg   ondansetron (ZOFRAN) injection solution 4 mg 4. Other headache syndrome  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   ondansetron (ZOFRAN) injection solution 4 mg   ketorolac (TORADOL) intravenous injection 15 mg 5. Shortness of breath  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   D-DIMER QUANTITATIVE   TROPONIN I   EKG   LACTIC ACID   ESR   CULTURE, BLOOD   BRAIN NATRIURETIC PEPTIDE   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE -   CTA CHEST   TROPONIN I 6. PAH (pulmonary arterial hypertension) with portal hypertension  BLOOD GASES VENOUS 7. Elevated troponin level    8. Positive D dimer  CTA CHEST 9. Elevated serum lactate dehydrogenase (LDH)    10. AKI (acute kidney injury)  URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE   sodium chloride 0.9% (bolus) IV solution 250 mL 11. Liver cirrhosis secondary to NASH  PROTIME/INR   PTT     ASSESSMENT/PLAN/DECISION MAKING: -Transferred to another healthcare facility.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram, Fibrin D dimer, Full blood count, Headache, Hepatic cirrhosis
Clinical narrative: 74yr old female who presents to ED with complaints of not feeling well.  Patient states she woke up yesterday morning with a headache and body aches.  Patient states she has had a fever and an increase in her cough.  Patient states she has been coughing up thick, yellow phlegm.  States she feels short of breath with exertion. Patient on O2 via NC at 4L, states this is her normal at home. Patient states she has diarrhea but states this is not new for her.  Patient states she has had the dry heaves.  Patient states they had a family gathering over the weekend.  Patient states she has been vaccinated for covid.  Pneumonia due to COVID-19 virus  AIRBORNE PRECAUTIONS    CONTACT PRECAUTIONS   INFECTION CONTROL REFERRAL   CULTURE, BLOOD   FERRITIN   LDH TOTAL   CK   cefTRIAXone (ROCEPHIN) in D-2.22% 50 mL IV piggyback (DUPLEX) (premix) 2,000 mg 2. Cough  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   LACTIC ACID   ESR   BLOOD GASES VENOUS   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE - 3. Nausea  ondansetron (ZOFRAN) injection solution 4 mg   ondansetron (ZOFRAN) injection solution 4 mg 4. Other headache syndrome  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   ondansetron (ZOFRAN) injection solution 4 mg   ketorolac (TORADOL) intravenous injection 15 mg 5. Shortness of breath  INFECTION CONTROL REFERRAL   SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL   COMPLETE BLOOD COUNT WITH DIFFERENTIAL   COMPREHENSIVE METABOLIC PANEL   C-REACTIVE PROTEIN (INFLAMMATION)   D-DIMER QUANTITATIVE   TROPONIN I   EKG   LACTIC ACID   ESR   CULTURE, BLOOD   BRAIN NATRIURETIC PEPTIDE   albuterol-ipratropium (DUO-NEB) 2.5-0.5 mg/3 mL inhalation solution 3 mL   methylPREDNISolone sod succ (SOLU-medrol) injection 60 mg   PROCALCITONIN   XRAY CHEST PORTABLE -   CTA CHEST   TROPONIN I 6. PAH (pulmonary arterial hypertension) with portal hypertension  BLOOD GASES VENOUS 7. Elevated troponin level    8. Positive D dimer  CTA CHEST 9. Elevated serum lactate dehydrogenase (LDH)    10. AKI (acute kidney injury)  URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE   sodium chloride 0.9% (bolus) IV solution 250 mL 11. Liver cirrhosis secondary to NASH  PROTIME/INR   PTT     ASSESSMENT/PLAN/DECISION MAKING: -Transferred to another healthcare facility.