chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood pressure increased, Blood sodium decreased, Blood urea increased, COVID-19, Cellulitis
Clinical narrative: 78 y/o female ( pt) with PMH of BLLE lymphedema, chronic wounds, and recurrent cellulitis.  She presents s/p falls x2 last night with increased illness, increased lower extremity pain, redness, swelling,  and worsening purulence  despite being on oral bactrim and keflex since 1/18/22.  She was last admitted here in Sept 2021 w/  b/l lower extremity cellulitis (no bacteremia) and treated with IV cefazolin with improvement.  No wound cx avail  from that visit but records show  prev  cultures were positive for PSAR,  +Corynebacterium striatum and have been periodic dating back to 2019. The patient notes she is seen by Dr in the wound clinic and also Dr  has followed and treated her with both oral an antibx and IV courses at the facility.  She denies previous surgical interventions such as debridements and has had no recent hospitalizations elsewhere.  She notes she has been quite weak the last few days, and had #2 falls last night where she just collapses.   She stated no LOC. She c/o's acute on chronic Left hip/buttock pain and is restless on stretcher.   She has had intermittent chills, no fevers, no n/v/d and has been eating normally, no urinary symptoms (other than chronic incontinence-wearing diaper), she is voiding, no ShOB, no CP, no syncope, no palpitations  but reports a chronic productive cough  --she keeps expectorating pale tan phlegm in room-- no hemoptysis; c/o thirst   Mild nausea, no diarrhea, no abd pain.  She is constipated--last BM 34 days ago. In the ER  she is afebrile.  BPs on higher side,  HRs stable in NSR on monitor; no respiratory distress.   NCCT Head: no  acute IC abnormality;  there is acute sinus dis.  pCXR and Left hip/pelvic XR pndg--note has h/o severe OA with avascular necrosis possibly noted in past.     Her labs show leukocytosis to 19K, left shift,  PCT elevated @ 1.42, hgb 8.8 (from 9.3 in Dec).  Sodium 127,  K+ 6 (4.8 in Dec), Cl 93, bicarb 18, no gap, BUN/creat 149/3.4 (73/1.5 in Dec),  CK pndg, gluc 119,lactate 1.4, COVID -19 positive (was known positive 1/13/22 --asymptomatic though chronic cough).  WC ordered  1/17/22 Outpt WC obtained by Dr positive for GBS, light PSAR (pansensitive), light MRSA w/ MDRO. She meets sepsis criteria w/ qSOFA of 2..  She received 500 cc of IV NS in ED --will cont w NS @ 125cc/h, and started on IV vanco, cefepime, & LVQ.   Hospital Medicine has been asked to admit the patient.    PT IS INPATIENT AT THIS TIME.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Condition aggravated, Constipation, Cough, Culture wound positive
Clinical narrative: 78 y/o female ( pt) with PMH of BLLE lymphedema, chronic wounds, and recurrent cellulitis.  She presents s/p falls x2 last night with increased illness, increased lower extremity pain, redness, swelling,  and worsening purulence  despite being on oral bactrim and keflex since 1/18/22.  She was last admitted here in Sept 2021 w/  b/l lower extremity cellulitis (no bacteremia) and treated with IV cefazolin with improvement.  No wound cx avail  from that visit but records show  prev  cultures were positive for PSAR,  +Corynebacterium striatum and have been periodic dating back to 2019. The patient notes she is seen by Dr in the wound clinic and also Dr  has followed and treated her with both oral an antibx and IV courses at the facility.  She denies previous surgical interventions such as debridements and has had no recent hospitalizations elsewhere.  She notes she has been quite weak the last few days, and had #2 falls last night where she just collapses.   She stated no LOC. She c/o's acute on chronic Left hip/buttock pain and is restless on stretcher.   She has had intermittent chills, no fevers, no n/v/d and has been eating normally, no urinary symptoms (other than chronic incontinence-wearing diaper), she is voiding, no ShOB, no CP, no syncope, no palpitations  but reports a chronic productive cough  --she keeps expectorating pale tan phlegm in room-- no hemoptysis; c/o thirst   Mild nausea, no diarrhea, no abd pain.  She is constipated--last BM 34 days ago. In the ER  she is afebrile.  BPs on higher side,  HRs stable in NSR on monitor; no respiratory distress.   NCCT Head: no  acute IC abnormality;  there is acute sinus dis.  pCXR and Left hip/pelvic XR pndg--note has h/o severe OA with avascular necrosis possibly noted in past.     Her labs show leukocytosis to 19K, left shift,  PCT elevated @ 1.42, hgb 8.8 (from 9.3 in Dec).  Sodium 127,  K+ 6 (4.8 in Dec), Cl 93, bicarb 18, no gap, BUN/creat 149/3.4 (73/1.5 in Dec),  CK pndg, gluc 119,lactate 1.4, COVID -19 positive (was known positive 1/13/22 --asymptomatic though chronic cough).  WC ordered  1/17/22 Outpt WC obtained by Dr positive for GBS, light PSAR (pansensitive), light MRSA w/ MDRO. She meets sepsis criteria w/ qSOFA of 2..  She received 500 cc of IV NS in ED --will cont w NS @ 125cc/h, and started on IV vanco, cefepime, & LVQ.   Hospital Medicine has been asked to admit the patient.    PT IS INPATIENT AT THIS TIME.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Erythema, Fall, Guillain-Barre syndrome, Haemoglobin decreased, Illness
Clinical narrative: 78 y/o female ( pt) with PMH of BLLE lymphedema, chronic wounds, and recurrent cellulitis.  She presents s/p falls x2 last night with increased illness, increased lower extremity pain, redness, swelling,  and worsening purulence  despite being on oral bactrim and keflex since 1/18/22.  She was last admitted here in Sept 2021 w/  b/l lower extremity cellulitis (no bacteremia) and treated with IV cefazolin with improvement.  No wound cx avail  from that visit but records show  prev  cultures were positive for PSAR,  +Corynebacterium striatum and have been periodic dating back to 2019. The patient notes she is seen by Dr in the wound clinic and also Dr  has followed and treated her with both oral an antibx and IV courses at the facility.  She denies previous surgical interventions such as debridements and has had no recent hospitalizations elsewhere.  She notes she has been quite weak the last few days, and had #2 falls last night where she just collapses.   She stated no LOC. She c/o's acute on chronic Left hip/buttock pain and is restless on stretcher.   She has had intermittent chills, no fevers, no n/v/d and has been eating normally, no urinary symptoms (other than chronic incontinence-wearing diaper), she is voiding, no ShOB, no CP, no syncope, no palpitations  but reports a chronic productive cough  --she keeps expectorating pale tan phlegm in room-- no hemoptysis; c/o thirst   Mild nausea, no diarrhea, no abd pain.  She is constipated--last BM 34 days ago. In the ER  she is afebrile.  BPs on higher side,  HRs stable in NSR on monitor; no respiratory distress.   NCCT Head: no  acute IC abnormality;  there is acute sinus dis.  pCXR and Left hip/pelvic XR pndg--note has h/o severe OA with avascular necrosis possibly noted in past.     Her labs show leukocytosis to 19K, left shift,  PCT elevated @ 1.42, hgb 8.8 (from 9.3 in Dec).  Sodium 127,  K+ 6 (4.8 in Dec), Cl 93, bicarb 18, no gap, BUN/creat 149/3.4 (73/1.5 in Dec),  CK pndg, gluc 119,lactate 1.4, COVID -19 positive (was known positive 1/13/22 --asymptomatic though chronic cough).  WC ordered  1/17/22 Outpt WC obtained by Dr positive for GBS, light PSAR (pansensitive), light MRSA w/ MDRO. She meets sepsis criteria w/ qSOFA of 2..  She received 500 cc of IV NS in ED --will cont w NS @ 125cc/h, and started on IV vanco, cefepime, & LVQ.   Hospital Medicine has been asked to admit the patient.    PT IS INPATIENT AT THIS TIME.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Incontinence, Infection, Leukocytosis, Musculoskeletal pain, Nausea
Clinical narrative: 78 y/o female ( pt) with PMH of BLLE lymphedema, chronic wounds, and recurrent cellulitis.  She presents s/p falls x2 last night with increased illness, increased lower extremity pain, redness, swelling,  and worsening purulence  despite being on oral bactrim and keflex since 1/18/22.  She was last admitted here in Sept 2021 w/  b/l lower extremity cellulitis (no bacteremia) and treated with IV cefazolin with improvement.  No wound cx avail  from that visit but records show  prev  cultures were positive for PSAR,  +Corynebacterium striatum and have been periodic dating back to 2019. The patient notes she is seen by Dr in the wound clinic and also Dr  has followed and treated her with both oral an antibx and IV courses at the facility.  She denies previous surgical interventions such as debridements and has had no recent hospitalizations elsewhere.  She notes she has been quite weak the last few days, and had #2 falls last night where she just collapses.   She stated no LOC. She c/o's acute on chronic Left hip/buttock pain and is restless on stretcher.   She has had intermittent chills, no fevers, no n/v/d and has been eating normally, no urinary symptoms (other than chronic incontinence-wearing diaper), she is voiding, no ShOB, no CP, no syncope, no palpitations  but reports a chronic productive cough  --she keeps expectorating pale tan phlegm in room-- no hemoptysis; c/o thirst   Mild nausea, no diarrhea, no abd pain.  She is constipated--last BM 34 days ago. In the ER  she is afebrile.  BPs on higher side,  HRs stable in NSR on monitor; no respiratory distress.   NCCT Head: no  acute IC abnormality;  there is acute sinus dis.  pCXR and Left hip/pelvic XR pndg--note has h/o severe OA with avascular necrosis possibly noted in past.     Her labs show leukocytosis to 19K, left shift,  PCT elevated @ 1.42, hgb 8.8 (from 9.3 in Dec).  Sodium 127,  K+ 6 (4.8 in Dec), Cl 93, bicarb 18, no gap, BUN/creat 149/3.4 (73/1.5 in Dec),  CK pndg, gluc 119,lactate 1.4, COVID -19 positive (was known positive 1/13/22 --asymptomatic though chronic cough).  WC ordered  1/17/22 Outpt WC obtained by Dr positive for GBS, light PSAR (pansensitive), light MRSA w/ MDRO. She meets sepsis criteria w/ qSOFA of 2..  She received 500 cc of IV NS in ED --will cont w NS @ 125cc/h, and started on IV vanco, cefepime, & LVQ.   Hospital Medicine has been asked to admit the patient.    PT IS INPATIENT AT THIS TIME.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pain in extremity, Procalcitonin increased, Productive cough, Pseudomonas infection, Purulence
Clinical narrative: 78 y/o female ( pt) with PMH of BLLE lymphedema, chronic wounds, and recurrent cellulitis.  She presents s/p falls x2 last night with increased illness, increased lower extremity pain, redness, swelling,  and worsening purulence  despite being on oral bactrim and keflex since 1/18/22.  She was last admitted here in Sept 2021 w/  b/l lower extremity cellulitis (no bacteremia) and treated with IV cefazolin with improvement.  No wound cx avail  from that visit but records show  prev  cultures were positive for PSAR,  +Corynebacterium striatum and have been periodic dating back to 2019. The patient notes she is seen by Dr in the wound clinic and also Dr  has followed and treated her with both oral an antibx and IV courses at the facility.  She denies previous surgical interventions such as debridements and has had no recent hospitalizations elsewhere.  She notes she has been quite weak the last few days, and had #2 falls last night where she just collapses.   She stated no LOC. She c/o's acute on chronic Left hip/buttock pain and is restless on stretcher.   She has had intermittent chills, no fevers, no n/v/d and has been eating normally, no urinary symptoms (other than chronic incontinence-wearing diaper), she is voiding, no ShOB, no CP, no syncope, no palpitations  but reports a chronic productive cough  --she keeps expectorating pale tan phlegm in room-- no hemoptysis; c/o thirst   Mild nausea, no diarrhea, no abd pain.  She is constipated--last BM 34 days ago. In the ER  she is afebrile.  BPs on higher side,  HRs stable in NSR on monitor; no respiratory distress.   NCCT Head: no  acute IC abnormality;  there is acute sinus dis.  pCXR and Left hip/pelvic XR pndg--note has h/o severe OA with avascular necrosis possibly noted in past.     Her labs show leukocytosis to 19K, left shift,  PCT elevated @ 1.42, hgb 8.8 (from 9.3 in Dec).  Sodium 127,  K+ 6 (4.8 in Dec), Cl 93, bicarb 18, no gap, BUN/creat 149/3.4 (73/1.5 in Dec),  CK pndg, gluc 119,lactate 1.4, COVID -19 positive (was known positive 1/13/22 --asymptomatic though chronic cough).  WC ordered  1/17/22 Outpt WC obtained by Dr positive for GBS, light PSAR (pansensitive), light MRSA w/ MDRO. She meets sepsis criteria w/ qSOFA of 2..  She received 500 cc of IV NS in ED --will cont w NS @ 125cc/h, and started on IV vanco, cefepime, & LVQ.   Hospital Medicine has been asked to admit the patient.    PT IS INPATIENT AT THIS TIME.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Restlessness, SARS-CoV-2 test positive, Sepsis, Sinus disorder, Sputum discoloured
Clinical narrative: 78 y/o female ( pt) with PMH of BLLE lymphedema, chronic wounds, and recurrent cellulitis.  She presents s/p falls x2 last night with increased illness, increased lower extremity pain, redness, swelling,  and worsening purulence  despite being on oral bactrim and keflex since 1/18/22.  She was last admitted here in Sept 2021 w/  b/l lower extremity cellulitis (no bacteremia) and treated with IV cefazolin with improvement.  No wound cx avail  from that visit but records show  prev  cultures were positive for PSAR,  +Corynebacterium striatum and have been periodic dating back to 2019. The patient notes she is seen by Dr in the wound clinic and also Dr  has followed and treated her with both oral an antibx and IV courses at the facility.  She denies previous surgical interventions such as debridements and has had no recent hospitalizations elsewhere.  She notes she has been quite weak the last few days, and had #2 falls last night where she just collapses.   She stated no LOC. She c/o's acute on chronic Left hip/buttock pain and is restless on stretcher.   She has had intermittent chills, no fevers, no n/v/d and has been eating normally, no urinary symptoms (other than chronic incontinence-wearing diaper), she is voiding, no ShOB, no CP, no syncope, no palpitations  but reports a chronic productive cough  --she keeps expectorating pale tan phlegm in room-- no hemoptysis; c/o thirst   Mild nausea, no diarrhea, no abd pain.  She is constipated--last BM 34 days ago. In the ER  she is afebrile.  BPs on higher side,  HRs stable in NSR on monitor; no respiratory distress.   NCCT Head: no  acute IC abnormality;  there is acute sinus dis.  pCXR and Left hip/pelvic XR pndg--note has h/o severe OA with avascular necrosis possibly noted in past.     Her labs show leukocytosis to 19K, left shift,  PCT elevated @ 1.42, hgb 8.8 (from 9.3 in Dec).  Sodium 127,  K+ 6 (4.8 in Dec), Cl 93, bicarb 18, no gap, BUN/creat 149/3.4 (73/1.5 in Dec),  CK pndg, gluc 119,lactate 1.4, COVID -19 positive (was known positive 1/13/22 --asymptomatic though chronic cough).  WC ordered  1/17/22 Outpt WC obtained by Dr positive for GBS, light PSAR (pansensitive), light MRSA w/ MDRO. She meets sepsis criteria w/ qSOFA of 2..  She received 500 cc of IV NS in ED --will cont w NS @ 125cc/h, and started on IV vanco, cefepime, & LVQ.   Hospital Medicine has been asked to admit the patient.    PT IS INPATIENT AT THIS TIME.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Staphylococcal infection, Swelling, Syncope, Thirst, X-ray of pelvis and hip
Clinical narrative: 78 y/o female ( pt) with PMH of BLLE lymphedema, chronic wounds, and recurrent cellulitis.  She presents s/p falls x2 last night with increased illness, increased lower extremity pain, redness, swelling,  and worsening purulence  despite being on oral bactrim and keflex since 1/18/22.  She was last admitted here in Sept 2021 w/  b/l lower extremity cellulitis (no bacteremia) and treated with IV cefazolin with improvement.  No wound cx avail  from that visit but records show  prev  cultures were positive for PSAR,  +Corynebacterium striatum and have been periodic dating back to 2019. The patient notes she is seen by Dr in the wound clinic and also Dr  has followed and treated her with both oral an antibx and IV courses at the facility.  She denies previous surgical interventions such as debridements and has had no recent hospitalizations elsewhere.  She notes she has been quite weak the last few days, and had #2 falls last night where she just collapses.   She stated no LOC. She c/o's acute on chronic Left hip/buttock pain and is restless on stretcher.   She has had intermittent chills, no fevers, no n/v/d and has been eating normally, no urinary symptoms (other than chronic incontinence-wearing diaper), she is voiding, no ShOB, no CP, no syncope, no palpitations  but reports a chronic productive cough  --she keeps expectorating pale tan phlegm in room-- no hemoptysis; c/o thirst   Mild nausea, no diarrhea, no abd pain.  She is constipated--last BM 34 days ago. In the ER  she is afebrile.  BPs on higher side,  HRs stable in NSR on monitor; no respiratory distress.   NCCT Head: no  acute IC abnormality;  there is acute sinus dis.  pCXR and Left hip/pelvic XR pndg--note has h/o severe OA with avascular necrosis possibly noted in past.     Her labs show leukocytosis to 19K, left shift,  PCT elevated @ 1.42, hgb 8.8 (from 9.3 in Dec).  Sodium 127,  K+ 6 (4.8 in Dec), Cl 93, bicarb 18, no gap, BUN/creat 149/3.4 (73/1.5 in Dec),  CK pndg, gluc 119,lactate 1.4, COVID -19 positive (was known positive 1/13/22 --asymptomatic though chronic cough).  WC ordered  1/17/22 Outpt WC obtained by Dr positive for GBS, light PSAR (pansensitive), light MRSA w/ MDRO. She meets sepsis criteria w/ qSOFA of 2..  She received 500 cc of IV NS in ED --will cont w NS @ 125cc/h, and started on IV vanco, cefepime, & LVQ.   Hospital Medicine has been asked to admit the patient.    PT IS INPATIENT AT THIS TIME.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Hospitalization.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Arthralgia, Body temperature increased, COVID-19, Dizziness, Fall
Clinical narrative: Patient is a 56 yr old male with medical history significant for cirrhosis with history of hep B and hep C which he states have both been treated and cleared, chronic back pain on daily opioids, CAD with stents, DM2, and depression/anxiety on daily diazepam. He reports that he had been feeling dizzy all day today, and when he stood up from the toilet, he again became dizzy and fell, landing on his R hip. He also reports that he hit his R forehead, but has no bruising or pain there, no headache. He is unsure why he was dizzy today, but states it may be due to his oxycodone and diazepam, although he takes these every day without dizziness. Due to severe R hip pain, EMS was called and he was brought in to ED for  further evaluation. In the ED, Xrays reveal mildly displaced R femoral neck fracture and L lateral 9th rib fracture without displacement or pneumothorax. He is pancytopenic with WBC 1.7, hgb 11.6, and plt 39. He has a temp of 99.4 and COVID test was positive. He is fully vaccinated and boosted, booster was given in October 2021. He denies SOB, denies cough, denies any COVID symptoms. Recorded O2 saturations noted to be variable from 97% on room air to 89% on 2L per cannula. Dr  has been consulted and hip repair is planned for tomorrow. He has received dilaudid and zofran in the ED, and the hospitalist service is asked for admission.  PT IS INPATIENT AT THIS TIME.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Femoral neck fracture, Haemoglobin decreased, Head injury, Joint injury, Pancytopenia
Clinical narrative: Patient is a 56 yr old male with medical history significant for cirrhosis with history of hep B and hep C which he states have both been treated and cleared, chronic back pain on daily opioids, CAD with stents, DM2, and depression/anxiety on daily diazepam. He reports that he had been feeling dizzy all day today, and when he stood up from the toilet, he again became dizzy and fell, landing on his R hip. He also reports that he hit his R forehead, but has no bruising or pain there, no headache. He is unsure why he was dizzy today, but states it may be due to his oxycodone and diazepam, although he takes these every day without dizziness. Due to severe R hip pain, EMS was called and he was brought in to ED for  further evaluation. In the ED, Xrays reveal mildly displaced R femoral neck fracture and L lateral 9th rib fracture without displacement or pneumothorax. He is pancytopenic with WBC 1.7, hgb 11.6, and plt 39. He has a temp of 99.4 and COVID test was positive. He is fully vaccinated and boosted, booster was given in October 2021. He denies SOB, denies cough, denies any COVID symptoms. Recorded O2 saturations noted to be variable from 97% on room air to 89% on 2L per cannula. Dr  has been consulted and hip repair is planned for tomorrow. He has received dilaudid and zofran in the ED, and the hospitalist service is asked for admission.  PT IS INPATIENT AT THIS TIME.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Platelet count decreased, Rib fracture, SARS-CoV-2 test positive, White blood cell count decreased, X-ray abnormal
Clinical narrative: Patient is a 56 yr old male with medical history significant for cirrhosis with history of hep B and hep C which he states have both been treated and cleared, chronic back pain on daily opioids, CAD with stents, DM2, and depression/anxiety on daily diazepam. He reports that he had been feeling dizzy all day today, and when he stood up from the toilet, he again became dizzy and fell, landing on his R hip. He also reports that he hit his R forehead, but has no bruising or pain there, no headache. He is unsure why he was dizzy today, but states it may be due to his oxycodone and diazepam, although he takes these every day without dizziness. Due to severe R hip pain, EMS was called and he was brought in to ED for  further evaluation. In the ED, Xrays reveal mildly displaced R femoral neck fracture and L lateral 9th rib fracture without displacement or pneumothorax. He is pancytopenic with WBC 1.7, hgb 11.6, and plt 39. He has a temp of 99.4 and COVID test was positive. He is fully vaccinated and boosted, booster was given in October 2021. He denies SOB, denies cough, denies any COVID symptoms. Recorded O2 saturations noted to be variable from 97% on room air to 89% on 2L per cannula. Dr  has been consulted and hip repair is planned for tomorrow. He has received dilaudid and zofran in the ED, and the hospitalist service is asked for admission.  PT IS INPATIENT AT THIS TIME.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Eye irritation, Headache, Pyrexia
Clinical narrative: tested positive for covid  burning eyes,  headache, chills, fever
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: tested positive for covid  burning eyes,  headache, chills, fever
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Facial bones fracture, Fall, General physical condition abnormal, Head injury, Loss of consciousness
Clinical narrative: Fell unconscious, hit head, broke nose, was never the same after, reports son.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Blood creatinine normal, Blood gases, Blood glucose normal, Blood pH normal
Clinical narrative: Patient is an 86 y/o woman with a PMHx of COPD on 2L, HTN, hyperlipidemia, and hypothyroidism. She presented to the ED today (1/23) due to worsening shortness of breath, N/V, and decreased PO intake. She states she first started feeling ill 9 days ago, on 1/14. She initially felt congested and had a sore throat. She then developed N/V and shortness of breath. She was evaluated in the ED on 1/17 and tested positive for COVID that day. She was stable on her home O2 rate of 2L and was therefore sent home with supportive care. She has continued to worsen over the past 5 days with increased work of breathing/shortness of breath and N/V with decreased oral intake. She reports mildly elevated temp of 100.7 F at home.She has been generally weak and just overall feeling ill.  In the ED her BP is stable and she is afebrile. ABG on 2L with pH 7.49, pCO2 38, pO2 70, O2 sat 95% on 2L. She has had tachypnea/increased work of breathing so she was placed on 30L at 30% HHFNC. CXR shows patchy LLL airspace disease. CTA chest is negative for PE but shows patchy bilateral lower lobe airspace disease. Labs with WBC 10.64, Hgb 13, NA 139, K 4.2, BUN 11.4, Cr 0.9, glucose 100, procal 0.18. Hospitalist service contacted for admission.    PT IS INPATIENT AT THIS TIME.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood potassium normal, Blood sodium normal, Blood urea increased, Body temperature increased, COVID-19
Clinical narrative: Patient is an 86 y/o woman with a PMHx of COPD on 2L, HTN, hyperlipidemia, and hypothyroidism. She presented to the ED today (1/23) due to worsening shortness of breath, N/V, and decreased PO intake. She states she first started feeling ill 9 days ago, on 1/14. She initially felt congested and had a sore throat. She then developed N/V and shortness of breath. She was evaluated in the ED on 1/17 and tested positive for COVID that day. She was stable on her home O2 rate of 2L and was therefore sent home with supportive care. She has continued to worsen over the past 5 days with increased work of breathing/shortness of breath and N/V with decreased oral intake. She reports mildly elevated temp of 100.7 F at home.She has been generally weak and just overall feeling ill.  In the ED her BP is stable and she is afebrile. ABG on 2L with pH 7.49, pCO2 38, pO2 70, O2 sat 95% on 2L. She has had tachypnea/increased work of breathing so she was placed on 30L at 30% HHFNC. CXR shows patchy LLL airspace disease. CTA chest is negative for PE but shows patchy bilateral lower lobe airspace disease. Labs with WBC 10.64, Hgb 13, NA 139, K 4.2, BUN 11.4, Cr 0.9, glucose 100, procal 0.18. Hospitalist service contacted for admission.    PT IS INPATIENT AT THIS TIME.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray abnormal, Dyspnoea, Haemoglobin normal, Hypophagia, Lung disorder
Clinical narrative: Patient is an 86 y/o woman with a PMHx of COPD on 2L, HTN, hyperlipidemia, and hypothyroidism. She presented to the ED today (1/23) due to worsening shortness of breath, N/V, and decreased PO intake. She states she first started feeling ill 9 days ago, on 1/14. She initially felt congested and had a sore throat. She then developed N/V and shortness of breath. She was evaluated in the ED on 1/17 and tested positive for COVID that day. She was stable on her home O2 rate of 2L and was therefore sent home with supportive care. She has continued to worsen over the past 5 days with increased work of breathing/shortness of breath and N/V with decreased oral intake. She reports mildly elevated temp of 100.7 F at home.She has been generally weak and just overall feeling ill.  In the ED her BP is stable and she is afebrile. ABG on 2L with pH 7.49, pCO2 38, pO2 70, O2 sat 95% on 2L. She has had tachypnea/increased work of breathing so she was placed on 30L at 30% HHFNC. CXR shows patchy LLL airspace disease. CTA chest is negative for PE but shows patchy bilateral lower lobe airspace disease. Labs with WBC 10.64, Hgb 13, NA 139, K 4.2, BUN 11.4, Cr 0.9, glucose 100, procal 0.18. Hospitalist service contacted for admission.    PT IS INPATIENT AT THIS TIME.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Malaise, Nausea, Oropharyngeal pain, PCO2 normal, PO2 decreased
Clinical narrative: Patient is an 86 y/o woman with a PMHx of COPD on 2L, HTN, hyperlipidemia, and hypothyroidism. She presented to the ED today (1/23) due to worsening shortness of breath, N/V, and decreased PO intake. She states she first started feeling ill 9 days ago, on 1/14. She initially felt congested and had a sore throat. She then developed N/V and shortness of breath. She was evaluated in the ED on 1/17 and tested positive for COVID that day. She was stable on her home O2 rate of 2L and was therefore sent home with supportive care. She has continued to worsen over the past 5 days with increased work of breathing/shortness of breath and N/V with decreased oral intake. She reports mildly elevated temp of 100.7 F at home.She has been generally weak and just overall feeling ill.  In the ED her BP is stable and she is afebrile. ABG on 2L with pH 7.49, pCO2 38, pO2 70, O2 sat 95% on 2L. She has had tachypnea/increased work of breathing so she was placed on 30L at 30% HHFNC. CXR shows patchy LLL airspace disease. CTA chest is negative for PE but shows patchy bilateral lower lobe airspace disease. Labs with WBC 10.64, Hgb 13, NA 139, K 4.2, BUN 11.4, Cr 0.9, glucose 100, procal 0.18. Hospitalist service contacted for admission.    PT IS INPATIENT AT THIS TIME.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Procalcitonin, Respiratory tract congestion, SARS-CoV-2 test positive, Supportive care, Tachypnoea
Clinical narrative: Patient is an 86 y/o woman with a PMHx of COPD on 2L, HTN, hyperlipidemia, and hypothyroidism. She presented to the ED today (1/23) due to worsening shortness of breath, N/V, and decreased PO intake. She states she first started feeling ill 9 days ago, on 1/14. She initially felt congested and had a sore throat. She then developed N/V and shortness of breath. She was evaluated in the ED on 1/17 and tested positive for COVID that day. She was stable on her home O2 rate of 2L and was therefore sent home with supportive care. She has continued to worsen over the past 5 days with increased work of breathing/shortness of breath and N/V with decreased oral intake. She reports mildly elevated temp of 100.7 F at home.She has been generally weak and just overall feeling ill.  In the ED her BP is stable and she is afebrile. ABG on 2L with pH 7.49, pCO2 38, pO2 70, O2 sat 95% on 2L. She has had tachypnea/increased work of breathing so she was placed on 30L at 30% HHFNC. CXR shows patchy LLL airspace disease. CTA chest is negative for PE but shows patchy bilateral lower lobe airspace disease. Labs with WBC 10.64, Hgb 13, NA 139, K 4.2, BUN 11.4, Cr 0.9, glucose 100, procal 0.18. Hospitalist service contacted for admission.    PT IS INPATIENT AT THIS TIME.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Vomiting, White blood cell count normal
Clinical narrative: Patient is an 86 y/o woman with a PMHx of COPD on 2L, HTN, hyperlipidemia, and hypothyroidism. She presented to the ED today (1/23) due to worsening shortness of breath, N/V, and decreased PO intake. She states she first started feeling ill 9 days ago, on 1/14. She initially felt congested and had a sore throat. She then developed N/V and shortness of breath. She was evaluated in the ED on 1/17 and tested positive for COVID that day. She was stable on her home O2 rate of 2L and was therefore sent home with supportive care. She has continued to worsen over the past 5 days with increased work of breathing/shortness of breath and N/V with decreased oral intake. She reports mildly elevated temp of 100.7 F at home.She has been generally weak and just overall feeling ill.  In the ED her BP is stable and she is afebrile. ABG on 2L with pH 7.49, pCO2 38, pO2 70, O2 sat 95% on 2L. She has had tachypnea/increased work of breathing so she was placed on 30L at 30% HHFNC. CXR shows patchy LLL airspace disease. CTA chest is negative for PE but shows patchy bilateral lower lobe airspace disease. Labs with WBC 10.64, Hgb 13, NA 139, K 4.2, BUN 11.4, Cr 0.9, glucose 100, procal 0.18. Hospitalist service contacted for admission.    PT IS INPATIENT AT THIS TIME.
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccine was stored for freezer temperature too long. We have recommended to the patient to get revaccinated.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cardiac telemetry, Chest X-ray normal, Chest discomfort, Chest pain
Clinical narrative: The patient presents with Chest Pain  The patient is a 69 year old female, known to medical facility, with a past medical history as detailed below including No Known ASHD, Preserved LVEF, HTN, NIDDM, Hypothyroidism, and Family Hx CAD. She was seen in consultation per Dr. 12/10/15 due to a family history of CAD. Given she underwent Stress TTE 11/10/15, which was negative and her symptoms improved with protonix, it was felt to be related to GERD. She has since been lost to follow up.  She presented to  ED 1/23/22 secondary to chest pain and recent syncopal episode. Upon arrival, she was found to be afebrile with blood pressure 107/73, pulse 124, and SpO2 98%. Significant initial laboratory demonstrated COVID19+, troponin 14.6-- >14.5-- >14.5 and negative d-dimer. EKG demonstrated sinus tachycardia with no acute ST/T wave abnormalities and right axis deviation. CXR was negative for acute process. CT Head was negative for acute process. She was given full dose ASA and NTG and admitted for further workup. Cardiology was consulted on 1/24/22 to address her chest pain and syncope.  The patient reports a 2 month history of initially intermittent chest pain at both rest and with exertion which has become more constant over the last week.  She was recently hospitalized at Hospital 2 weeks ago at which time she underwent MPS which was reportedly negative.  Over the last week, she reports her chest pain has become more constant.  She describes central chest pressure and also a knife like twisting at times.  She reports it occasionally radiates to her left jaw.  The chest pain is worse with exertion and deep breathing at times. She has tried baking soda at home with some improvement.  Yesterday around 4:00 PM after getting up to walk to the bathroom, she became lightheaded with a tingling sensation in her head and subsequently slid down the wall.  She denies associated head injury, chest pain, or palpitations.  She feels that she did pass out for a few seconds. As such, she notified her son and the decision was made to proceed to the ER.  She describes a similar syncopal episode last week after getting up to walk into the kitchen.    She denies known cardiac history and has never undergone cardiac catheterization.  She reports a history of HTN and DM.  She is a nonsmoker.  She reports a strong family history of CAD in both parents and multiple siblings who reportedly had issues with a blockage "on the backside of their heart. "  She denies otherwise denies recent fever, chills, or known COVID exposure.  She does describe shortness of breath at both rest and with exertion over the last 2 days.  She denies cough, sore throat, or loss of taste/smell, She got her 2nd COVID vaccine 12/2021.  Presently, she is resting comfortably in bed and and reports resolution of her chest pain with NTG paste.  She denies chest pain or shortness of breath.  Telemetry is demonstrating NSR rate of 95 with blood pressure 164/95, and SpO2 100%/RA.  She is a widow and has 3 children.  PT IS INPATIENT AT THIS TIME.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer normal, Loss of consciousness, Pain, Pain in jaw, Painful respiration
Clinical narrative: The patient presents with Chest Pain  The patient is a 69 year old female, known to medical facility, with a past medical history as detailed below including No Known ASHD, Preserved LVEF, HTN, NIDDM, Hypothyroidism, and Family Hx CAD. She was seen in consultation per Dr. 12/10/15 due to a family history of CAD. Given she underwent Stress TTE 11/10/15, which was negative and her symptoms improved with protonix, it was felt to be related to GERD. She has since been lost to follow up.  She presented to  ED 1/23/22 secondary to chest pain and recent syncopal episode. Upon arrival, she was found to be afebrile with blood pressure 107/73, pulse 124, and SpO2 98%. Significant initial laboratory demonstrated COVID19+, troponin 14.6-- >14.5-- >14.5 and negative d-dimer. EKG demonstrated sinus tachycardia with no acute ST/T wave abnormalities and right axis deviation. CXR was negative for acute process. CT Head was negative for acute process. She was given full dose ASA and NTG and admitted for further workup. Cardiology was consulted on 1/24/22 to address her chest pain and syncope.  The patient reports a 2 month history of initially intermittent chest pain at both rest and with exertion which has become more constant over the last week.  She was recently hospitalized at Hospital 2 weeks ago at which time she underwent MPS which was reportedly negative.  Over the last week, she reports her chest pain has become more constant.  She describes central chest pressure and also a knife like twisting at times.  She reports it occasionally radiates to her left jaw.  The chest pain is worse with exertion and deep breathing at times. She has tried baking soda at home with some improvement.  Yesterday around 4:00 PM after getting up to walk to the bathroom, she became lightheaded with a tingling sensation in her head and subsequently slid down the wall.  She denies associated head injury, chest pain, or palpitations.  She feels that she did pass out for a few seconds. As such, she notified her son and the decision was made to proceed to the ER.  She describes a similar syncopal episode last week after getting up to walk into the kitchen.    She denies known cardiac history and has never undergone cardiac catheterization.  She reports a history of HTN and DM.  She is a nonsmoker.  She reports a strong family history of CAD in both parents and multiple siblings who reportedly had issues with a blockage "on the backside of their heart. "  She denies otherwise denies recent fever, chills, or known COVID exposure.  She does describe shortness of breath at both rest and with exertion over the last 2 days.  She denies cough, sore throat, or loss of taste/smell, She got her 2nd COVID vaccine 12/2021.  Presently, she is resting comfortably in bed and and reports resolution of her chest pain with NTG paste.  She denies chest pain or shortness of breath.  Telemetry is demonstrating NSR rate of 95 with blood pressure 164/95, and SpO2 100%/RA.  She is a widow and has 3 children.  PT IS INPATIENT AT THIS TIME.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia, SARS-CoV-2 test positive, Sinus tachycardia, Syncope, Troponin
Clinical narrative: The patient presents with Chest Pain  The patient is a 69 year old female, known to medical facility, with a past medical history as detailed below including No Known ASHD, Preserved LVEF, HTN, NIDDM, Hypothyroidism, and Family Hx CAD. She was seen in consultation per Dr. 12/10/15 due to a family history of CAD. Given she underwent Stress TTE 11/10/15, which was negative and her symptoms improved with protonix, it was felt to be related to GERD. She has since been lost to follow up.  She presented to  ED 1/23/22 secondary to chest pain and recent syncopal episode. Upon arrival, she was found to be afebrile with blood pressure 107/73, pulse 124, and SpO2 98%. Significant initial laboratory demonstrated COVID19+, troponin 14.6-- >14.5-- >14.5 and negative d-dimer. EKG demonstrated sinus tachycardia with no acute ST/T wave abnormalities and right axis deviation. CXR was negative for acute process. CT Head was negative for acute process. She was given full dose ASA and NTG and admitted for further workup. Cardiology was consulted on 1/24/22 to address her chest pain and syncope.  The patient reports a 2 month history of initially intermittent chest pain at both rest and with exertion which has become more constant over the last week.  She was recently hospitalized at Hospital 2 weeks ago at which time she underwent MPS which was reportedly negative.  Over the last week, she reports her chest pain has become more constant.  She describes central chest pressure and also a knife like twisting at times.  She reports it occasionally radiates to her left jaw.  The chest pain is worse with exertion and deep breathing at times. She has tried baking soda at home with some improvement.  Yesterday around 4:00 PM after getting up to walk to the bathroom, she became lightheaded with a tingling sensation in her head and subsequently slid down the wall.  She denies associated head injury, chest pain, or palpitations.  She feels that she did pass out for a few seconds. As such, she notified her son and the decision was made to proceed to the ER.  She describes a similar syncopal episode last week after getting up to walk into the kitchen.    She denies known cardiac history and has never undergone cardiac catheterization.  She reports a history of HTN and DM.  She is a nonsmoker.  She reports a strong family history of CAD in both parents and multiple siblings who reportedly had issues with a blockage "on the backside of their heart. "  She denies otherwise denies recent fever, chills, or known COVID exposure.  She does describe shortness of breath at both rest and with exertion over the last 2 days.  She denies cough, sore throat, or loss of taste/smell, She got her 2nd COVID vaccine 12/2021.  Presently, she is resting comfortably in bed and and reports resolution of her chest pain with NTG paste.  She denies chest pain or shortness of breath.  Telemetry is demonstrating NSR rate of 95 with blood pressure 164/95, and SpO2 100%/RA.  She is a widow and has 3 children.  PT IS INPATIENT AT THIS TIME.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, Atrial fibrillation, Bacterial test positive, Blood creatinine increased, Blood potassium normal
Clinical narrative: Patient is an 83 y/o woman with a PMHx of Alzheimer's dementia, HTN, and CKD III. She lives at a facility in the memory care unit. There have been multiple cases of COVID-19 so residents are being tested frequently. She tested positive for COVID-19 approx 6 days ago. She has reportedly had no fever or significant respiratory symptoms. She was transported to the ED today (1/23) due to generalized weakness, lethargy, and decreased oral intake. Patient is non-verbal at baseline due to her dementia but is typically able to ambulate and able to feed herself when encouraged to do so. Over the past 2 days she has not been eating or drinking. No reports of N/V or diarrhea. Facility has been increasingly concerned about patient and asked family to come see her. When family visited patient they were concerned about how dehydrated she appeared and how weak and frail she appears. She was sent to ED for further evaluation.  Upon arrival patient was noted to be in new onset rapid atrial fibrillation with HR in the 150s. BP has been stable. She is afebrile. O2 sat high 90s on RA. CXR unremarkable. VRAD report of head CT with no acute findings. UA with trace leuk est, 10-30 WBC, 4+ bacteria. COVID positive. Labs notable for WBC 14.97, Hgb 16.7, Na 156, K 4.4, BUN 65.9, Cr 2.2, procal 0.16. She was given diltiazem bolus and started on dilt gtt in the ED. She was given a dose of ceftriaxone and 1 L LR. Hospitalist service contacted for admission.  PT IS INPATIENT AT THIS TIME.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood sodium increased, Blood urea increased, COVID-19, Chest X-ray normal, Computerised tomogram head normal
Clinical narrative: Patient is an 83 y/o woman with a PMHx of Alzheimer's dementia, HTN, and CKD III. She lives at a facility in the memory care unit. There have been multiple cases of COVID-19 so residents are being tested frequently. She tested positive for COVID-19 approx 6 days ago. She has reportedly had no fever or significant respiratory symptoms. She was transported to the ED today (1/23) due to generalized weakness, lethargy, and decreased oral intake. Patient is non-verbal at baseline due to her dementia but is typically able to ambulate and able to feed herself when encouraged to do so. Over the past 2 days she has not been eating or drinking. No reports of N/V or diarrhea. Facility has been increasingly concerned about patient and asked family to come see her. When family visited patient they were concerned about how dehydrated she appeared and how weak and frail she appears. She was sent to ED for further evaluation.  Upon arrival patient was noted to be in new onset rapid atrial fibrillation with HR in the 150s. BP has been stable. She is afebrile. O2 sat high 90s on RA. CXR unremarkable. VRAD report of head CT with no acute findings. UA with trace leuk est, 10-30 WBC, 4+ bacteria. COVID positive. Labs notable for WBC 14.97, Hgb 16.7, Na 156, K 4.4, BUN 65.9, Cr 2.2, procal 0.16. She was given diltiazem bolus and started on dilt gtt in the ED. She was given a dose of ceftriaxone and 1 L LR. Hospitalist service contacted for admission.  PT IS INPATIENT AT THIS TIME.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Decreased appetite, Dehydration, Exposure to SARS-CoV-2, Haemoglobin increased, Hypophagia
Clinical narrative: Patient is an 83 y/o woman with a PMHx of Alzheimer's dementia, HTN, and CKD III. She lives at a facility in the memory care unit. There have been multiple cases of COVID-19 so residents are being tested frequently. She tested positive for COVID-19 approx 6 days ago. She has reportedly had no fever or significant respiratory symptoms. She was transported to the ED today (1/23) due to generalized weakness, lethargy, and decreased oral intake. Patient is non-verbal at baseline due to her dementia but is typically able to ambulate and able to feed herself when encouraged to do so. Over the past 2 days she has not been eating or drinking. No reports of N/V or diarrhea. Facility has been increasingly concerned about patient and asked family to come see her. When family visited patient they were concerned about how dehydrated she appeared and how weak and frail she appears. She was sent to ED for further evaluation.  Upon arrival patient was noted to be in new onset rapid atrial fibrillation with HR in the 150s. BP has been stable. She is afebrile. O2 sat high 90s on RA. CXR unremarkable. VRAD report of head CT with no acute findings. UA with trace leuk est, 10-30 WBC, 4+ bacteria. COVID positive. Labs notable for WBC 14.97, Hgb 16.7, Na 156, K 4.4, BUN 65.9, Cr 2.2, procal 0.16. She was given diltiazem bolus and started on dilt gtt in the ED. She was given a dose of ceftriaxone and 1 L LR. Hospitalist service contacted for admission.  PT IS INPATIENT AT THIS TIME.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Lethargy, Procalcitonin, SARS-CoV-2 test positive, Urine analysis abnormal, Urine leukocyte esterase positive
Clinical narrative: Patient is an 83 y/o woman with a PMHx of Alzheimer's dementia, HTN, and CKD III. She lives at a facility in the memory care unit. There have been multiple cases of COVID-19 so residents are being tested frequently. She tested positive for COVID-19 approx 6 days ago. She has reportedly had no fever or significant respiratory symptoms. She was transported to the ED today (1/23) due to generalized weakness, lethargy, and decreased oral intake. Patient is non-verbal at baseline due to her dementia but is typically able to ambulate and able to feed herself when encouraged to do so. Over the past 2 days she has not been eating or drinking. No reports of N/V or diarrhea. Facility has been increasingly concerned about patient and asked family to come see her. When family visited patient they were concerned about how dehydrated she appeared and how weak and frail she appears. She was sent to ED for further evaluation.  Upon arrival patient was noted to be in new onset rapid atrial fibrillation with HR in the 150s. BP has been stable. She is afebrile. O2 sat high 90s on RA. CXR unremarkable. VRAD report of head CT with no acute findings. UA with trace leuk est, 10-30 WBC, 4+ bacteria. COVID positive. Labs notable for WBC 14.97, Hgb 16.7, Na 156, K 4.4, BUN 65.9, Cr 2.2, procal 0.16. She was given diltiazem bolus and started on dilt gtt in the ED. She was given a dose of ceftriaxone and 1 L LR. Hospitalist service contacted for admission.  PT IS INPATIENT AT THIS TIME.