chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, Carbon dioxide decreased, Culture positive, Death
Clinical narrative: 7/20--8/2 57-year-old male, presented from Hospital with hypotension and shortness of breath. He entered Hospital for a "liver workup" and paracentesis. When he got hypotensive, he was transferred to facility. He also had 9000 cc ascitic fluid removed initially. He is COVID positive and is partially vaccinated. He is an ex-cigarette smoker with multiple comorbidities. His hemoglobin and sodium were low as was his CO2 and magnesium. His creatinine was elevated. The patient was treated initially with his usual medications including intravenous fluids, electrolytes, and he was started on Flagyl and vancomycin as well as Levophed for an initial low blood pressure.  His low magnesium was replaced and he had  positive MRSA in his nasal swab and was started on mupirocin.  At this time, COVID isolation was removed.  On 07/23, there was evidence of acute hypoxic respiratory failure and fluid overload.  Hypotension with possible sepsis from urinary tract infection was noted.  It is obvious he had decompensated cirrhosis with ascites and later required a second paracentesis.  His hemoglobin initially dropped.  He had evidence of bilateral pulmonary edema with a rising BNP and MRSA was in the respiratory culture.  He was continued on Flagyl and Vancomycin, and electrolytes were replaced as needed.  INR was as high as 2.9 and again, magnesium was low and had to be replaced.  BNP went up to 836 and metabolic acidosis was noted as well as portal hypertension earlier, requiring Blakemore tube.  Creatinine started to rise.  Metabolic acidosis was present and he continued to deteriorate and hospice was inquired.  His mentation was very poor and there was a question of anisocoria.  A CT of the head was ordered, but he continued to deteriorate and on 08/01/2022, he was discharged to inpatient hospice. Upon hourly rounding  patient assessed and unresponsive to verbal and tactile stimuli, pulseless, respirations and heartsounds absent.  Pupils dilated, fixed, and unresponsive to light.  Date and time of death pronounced on  8/2/22 at 0545.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Gastrointestinal tube insertion, General physical health deterioration, Haemoglobin decreased, Heart sounds abnormal
Clinical narrative: 7/20--8/2 57-year-old male, presented from Hospital with hypotension and shortness of breath. He entered Hospital for a "liver workup" and paracentesis. When he got hypotensive, he was transferred to facility. He also had 9000 cc ascitic fluid removed initially. He is COVID positive and is partially vaccinated. He is an ex-cigarette smoker with multiple comorbidities. His hemoglobin and sodium were low as was his CO2 and magnesium. His creatinine was elevated. The patient was treated initially with his usual medications including intravenous fluids, electrolytes, and he was started on Flagyl and vancomycin as well as Levophed for an initial low blood pressure.  His low magnesium was replaced and he had  positive MRSA in his nasal swab and was started on mupirocin.  At this time, COVID isolation was removed.  On 07/23, there was evidence of acute hypoxic respiratory failure and fluid overload.  Hypotension with possible sepsis from urinary tract infection was noted.  It is obvious he had decompensated cirrhosis with ascites and later required a second paracentesis.  His hemoglobin initially dropped.  He had evidence of bilateral pulmonary edema with a rising BNP and MRSA was in the respiratory culture.  He was continued on Flagyl and Vancomycin, and electrolytes were replaced as needed.  INR was as high as 2.9 and again, magnesium was low and had to be replaced.  BNP went up to 836 and metabolic acidosis was noted as well as portal hypertension earlier, requiring Blakemore tube.  Creatinine started to rise.  Metabolic acidosis was present and he continued to deteriorate and hospice was inquired.  His mentation was very poor and there was a question of anisocoria.  A CT of the head was ordered, but he continued to deteriorate and on 08/01/2022, he was discharged to inpatient hospice. Upon hourly rounding  patient assessed and unresponsive to verbal and tactile stimuli, pulseless, respirations and heartsounds absent.  Pupils dilated, fixed, and unresponsive to light.  Date and time of death pronounced on  8/2/22 at 0545.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hepatic cirrhosis, Hypervolaemia, Hypotension, International normalised ratio increased, Liver function test
Clinical narrative: 7/20--8/2 57-year-old male, presented from Hospital with hypotension and shortness of breath. He entered Hospital for a "liver workup" and paracentesis. When he got hypotensive, he was transferred to facility. He also had 9000 cc ascitic fluid removed initially. He is COVID positive and is partially vaccinated. He is an ex-cigarette smoker with multiple comorbidities. His hemoglobin and sodium were low as was his CO2 and magnesium. His creatinine was elevated. The patient was treated initially with his usual medications including intravenous fluids, electrolytes, and he was started on Flagyl and vancomycin as well as Levophed for an initial low blood pressure.  His low magnesium was replaced and he had  positive MRSA in his nasal swab and was started on mupirocin.  At this time, COVID isolation was removed.  On 07/23, there was evidence of acute hypoxic respiratory failure and fluid overload.  Hypotension with possible sepsis from urinary tract infection was noted.  It is obvious he had decompensated cirrhosis with ascites and later required a second paracentesis.  His hemoglobin initially dropped.  He had evidence of bilateral pulmonary edema with a rising BNP and MRSA was in the respiratory culture.  He was continued on Flagyl and Vancomycin, and electrolytes were replaced as needed.  INR was as high as 2.9 and again, magnesium was low and had to be replaced.  BNP went up to 836 and metabolic acidosis was noted as well as portal hypertension earlier, requiring Blakemore tube.  Creatinine started to rise.  Metabolic acidosis was present and he continued to deteriorate and hospice was inquired.  His mentation was very poor and there was a question of anisocoria.  A CT of the head was ordered, but he continued to deteriorate and on 08/01/2022, he was discharged to inpatient hospice. Upon hourly rounding  patient assessed and unresponsive to verbal and tactile stimuli, pulseless, respirations and heartsounds absent.  Pupils dilated, fixed, and unresponsive to light.  Date and time of death pronounced on  8/2/22 at 0545.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Mental impairment, Metabolic acidosis, Multimorbidity, Paracentesis, Portal hypertension
Clinical narrative: 7/20--8/2 57-year-old male, presented from Hospital with hypotension and shortness of breath. He entered Hospital for a "liver workup" and paracentesis. When he got hypotensive, he was transferred to facility. He also had 9000 cc ascitic fluid removed initially. He is COVID positive and is partially vaccinated. He is an ex-cigarette smoker with multiple comorbidities. His hemoglobin and sodium were low as was his CO2 and magnesium. His creatinine was elevated. The patient was treated initially with his usual medications including intravenous fluids, electrolytes, and he was started on Flagyl and vancomycin as well as Levophed for an initial low blood pressure.  His low magnesium was replaced and he had  positive MRSA in his nasal swab and was started on mupirocin.  At this time, COVID isolation was removed.  On 07/23, there was evidence of acute hypoxic respiratory failure and fluid overload.  Hypotension with possible sepsis from urinary tract infection was noted.  It is obvious he had decompensated cirrhosis with ascites and later required a second paracentesis.  His hemoglobin initially dropped.  He had evidence of bilateral pulmonary edema with a rising BNP and MRSA was in the respiratory culture.  He was continued on Flagyl and Vancomycin, and electrolytes were replaced as needed.  INR was as high as 2.9 and again, magnesium was low and had to be replaced.  BNP went up to 836 and metabolic acidosis was noted as well as portal hypertension earlier, requiring Blakemore tube.  Creatinine started to rise.  Metabolic acidosis was present and he continued to deteriorate and hospice was inquired.  His mentation was very poor and there was a question of anisocoria.  A CT of the head was ordered, but he continued to deteriorate and on 08/01/2022, he was discharged to inpatient hospice. Upon hourly rounding  patient assessed and unresponsive to verbal and tactile stimuli, pulseless, respirations and heartsounds absent.  Pupils dilated, fixed, and unresponsive to light.  Date and time of death pronounced on  8/2/22 at 0545.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pulmonary oedema, Pulse absent, Pupil fixed, Pupillary reflex impaired, Respiratory arrest
Clinical narrative: 7/20--8/2 57-year-old male, presented from Hospital with hypotension and shortness of breath. He entered Hospital for a "liver workup" and paracentesis. When he got hypotensive, he was transferred to facility. He also had 9000 cc ascitic fluid removed initially. He is COVID positive and is partially vaccinated. He is an ex-cigarette smoker with multiple comorbidities. His hemoglobin and sodium were low as was his CO2 and magnesium. His creatinine was elevated. The patient was treated initially with his usual medications including intravenous fluids, electrolytes, and he was started on Flagyl and vancomycin as well as Levophed for an initial low blood pressure.  His low magnesium was replaced and he had  positive MRSA in his nasal swab and was started on mupirocin.  At this time, COVID isolation was removed.  On 07/23, there was evidence of acute hypoxic respiratory failure and fluid overload.  Hypotension with possible sepsis from urinary tract infection was noted.  It is obvious he had decompensated cirrhosis with ascites and later required a second paracentesis.  His hemoglobin initially dropped.  He had evidence of bilateral pulmonary edema with a rising BNP and MRSA was in the respiratory culture.  He was continued on Flagyl and Vancomycin, and electrolytes were replaced as needed.  INR was as high as 2.9 and again, magnesium was low and had to be replaced.  BNP went up to 836 and metabolic acidosis was noted as well as portal hypertension earlier, requiring Blakemore tube.  Creatinine started to rise.  Metabolic acidosis was present and he continued to deteriorate and hospice was inquired.  His mentation was very poor and there was a question of anisocoria.  A CT of the head was ordered, but he continued to deteriorate and on 08/01/2022, he was discharged to inpatient hospice. Upon hourly rounding  patient assessed and unresponsive to verbal and tactile stimuli, pulseless, respirations and heartsounds absent.  Pupils dilated, fixed, and unresponsive to light.  Date and time of death pronounced on  8/2/22 at 0545.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Staphylococcus test positive, Unresponsive to stimuli, Urinary tract infection
Clinical narrative: 7/20--8/2 57-year-old male, presented from Hospital with hypotension and shortness of breath. He entered Hospital for a "liver workup" and paracentesis. When he got hypotensive, he was transferred to facility. He also had 9000 cc ascitic fluid removed initially. He is COVID positive and is partially vaccinated. He is an ex-cigarette smoker with multiple comorbidities. His hemoglobin and sodium were low as was his CO2 and magnesium. His creatinine was elevated. The patient was treated initially with his usual medications including intravenous fluids, electrolytes, and he was started on Flagyl and vancomycin as well as Levophed for an initial low blood pressure.  His low magnesium was replaced and he had  positive MRSA in his nasal swab and was started on mupirocin.  At this time, COVID isolation was removed.  On 07/23, there was evidence of acute hypoxic respiratory failure and fluid overload.  Hypotension with possible sepsis from urinary tract infection was noted.  It is obvious he had decompensated cirrhosis with ascites and later required a second paracentesis.  His hemoglobin initially dropped.  He had evidence of bilateral pulmonary edema with a rising BNP and MRSA was in the respiratory culture.  He was continued on Flagyl and Vancomycin, and electrolytes were replaced as needed.  INR was as high as 2.9 and again, magnesium was low and had to be replaced.  BNP went up to 836 and metabolic acidosis was noted as well as portal hypertension earlier, requiring Blakemore tube.  Creatinine started to rise.  Metabolic acidosis was present and he continued to deteriorate and hospice was inquired.  His mentation was very poor and there was a question of anisocoria.  A CT of the head was ordered, but he continued to deteriorate and on 08/01/2022, he was discharged to inpatient hospice. Upon hourly rounding  patient assessed and unresponsive to verbal and tactile stimuli, pulseless, respirations and heartsounds absent.  Pupils dilated, fixed, and unresponsive to light.  Date and time of death pronounced on  8/2/22 at 0545.
Age: 28.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Amniorrhoea, COVID-19, Delivery, Maternal exposure before pregnancy, SARS-CoV-2 test positive
Clinical narrative: 7/21--7/23 29y.o. G1P0 at 39w5d by L=8 5/7 wk US presents to Triage with c/o ctxs and LOF  @ 0700. Fetal movement normal. 7/21 SVD healthy baby. Discharged with baby 7/23.
Age: 28.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Ultrasound antenatal screen, Uterine contractions during pregnancy
Clinical narrative: 7/21--7/23 29y.o. G1P0 at 39w5d by L=8 5/7 wk US presents to Triage with c/o ctxs and LOF  @ 0700. Fetal movement normal. 7/21 SVD healthy baby. Discharged with baby 7/23.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Abdominal pain lower, Appendicectomy, Appendicitis, COVID-19
Clinical narrative: 7/17--7/20 52y.o. female who presented with RLQ abdominal pain and was found to have acute appendicitis with cecal involvement. Given higher risk of need for bowel resection she was nonoperatively managed. She was incidentally COVID positive and did have symptoms of congestion. She was admitted on IV abx and abdominal pain, nausea, and emesis improved over the next several days. Diet was advanced. Pain was controlled on PO medications. Patient was passing flatus and ambulating. The patient was deemed stable for discharge on hospital day 3 plan to complete a course of PO abx with interval colonoscopy prior to elective appendectomy.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Colonoscopy, Flatulence, Nausea, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: 7/17--7/20 52y.o. female who presented with RLQ abdominal pain and was found to have acute appendicitis with cecal involvement. Given higher risk of need for bowel resection she was nonoperatively managed. She was incidentally COVID positive and did have symptoms of congestion. She was admitted on IV abx and abdominal pain, nausea, and emesis improved over the next several days. Diet was advanced. Pain was controlled on PO medications. Patient was passing flatus and ambulating. The patient was deemed stable for discharge on hospital day 3 plan to complete a course of PO abx with interval colonoscopy prior to elective appendectomy.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Vomiting
Clinical narrative: 7/17--7/20 52y.o. female who presented with RLQ abdominal pain and was found to have acute appendicitis with cecal involvement. Given higher risk of need for bowel resection she was nonoperatively managed. She was incidentally COVID positive and did have symptoms of congestion. She was admitted on IV abx and abdominal pain, nausea, and emesis improved over the next several days. Diet was advanced. Pain was controlled on PO medications. Patient was passing flatus and ambulating. The patient was deemed stable for discharge on hospital day 3 plan to complete a course of PO abx with interval colonoscopy prior to elective appendectomy.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myocardial infarction, Atrial fibrillation, COVID-19, Condition aggravated, Coronary artery disease
Clinical narrative: 7/25--presently admitted 57y.o. year old male with past medical history significant for hypertension, hyperlipidemia, type 2 diabetes, obstructive sleep apnea, morbid obesity, psoriatic arthritis, and morbid obesity admitted for A. fib with RVR, NSTEMI, and newly diagnosed multivessel coronary artery disease.  Was eval by CT surgery found to be poor candidate for cardiac surgery but per chart review is willing to undergo high risk PCI. Patient incidentally tested positive for COVID-19 on 7/30/2022, cycle threshold was 19.1.  He is denied any shortness of breath or chest pain.  Overnight nursing note documented patient was snoring with oxygen saturation 82% breathing room air, upon awakening he quickly recovered to 95%. We have been asked for COVID-19 recommendations.  He was vaccinated with the Moderna vaccine in  9/2021 but has not been boosted. Initial encounter with patient found him sitting up at his bedside on his phone.  He is currently feeling well.  He is on room air only complains of his systemic psoriasis.  Specifically, he denies shortness of breath, chest pain, congestion, headache, sore throat, or any other symptoms.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Polymerase chain reaction, Psoriasis, SARS-CoV-2 test positive, Snoring
Clinical narrative: 7/25--presently admitted 57y.o. year old male with past medical history significant for hypertension, hyperlipidemia, type 2 diabetes, obstructive sleep apnea, morbid obesity, psoriatic arthritis, and morbid obesity admitted for A. fib with RVR, NSTEMI, and newly diagnosed multivessel coronary artery disease.  Was eval by CT surgery found to be poor candidate for cardiac surgery but per chart review is willing to undergo high risk PCI. Patient incidentally tested positive for COVID-19 on 7/30/2022, cycle threshold was 19.1.  He is denied any shortness of breath or chest pain.  Overnight nursing note documented patient was snoring with oxygen saturation 82% breathing room air, upon awakening he quickly recovered to 95%. We have been asked for COVID-19 recommendations.  He was vaccinated with the Moderna vaccine in  9/2021 but has not been boosted. Initial encounter with patient found him sitting up at his bedside on his phone.  He is currently feeling well.  He is on room air only complains of his systemic psoriasis.  Specifically, he denies shortness of breath, chest pain, congestion, headache, sore throat, or any other symptoms.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Arthralgia, COVID-19, Drug use disorder, Fall
Clinical narrative: 7/30--8/3 61 yo gentleman known to me from 2014 admission with history of hemorrhagic CVA , admitted with syncopal episode/ presyncopal episodes and falls in outpatient setting. Pain in left hip after previous fall- no obvious deformity, prior THA reported.  Rule out fracture. COVID 19 - with fever, leukocytosis.  Fatigue and malaise present.  On room air. Low procalcitonin lever. AKI with metabolic acidosis- likely prerenal. Recent rehab stay for cocaine use. Completing day 3 of 3 remdesivir.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Leukocytosis, Malaise, Metabolic acidosis, Presyncope
Clinical narrative: 7/30--8/3 61 yo gentleman known to me from 2014 admission with history of hemorrhagic CVA , admitted with syncopal episode/ presyncopal episodes and falls in outpatient setting. Pain in left hip after previous fall- no obvious deformity, prior THA reported.  Rule out fracture. COVID 19 - with fever, leukocytosis.  Fatigue and malaise present.  On room air. Low procalcitonin lever. AKI with metabolic acidosis- likely prerenal. Recent rehab stay for cocaine use. Completing day 3 of 3 remdesivir.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Procalcitonin decreased, Pyrexia, SARS-CoV-2 test positive, Syncope
Clinical narrative: 7/30--8/3 61 yo gentleman known to me from 2014 admission with history of hemorrhagic CVA , admitted with syncopal episode/ presyncopal episodes and falls in outpatient setting. Pain in left hip after previous fall- no obvious deformity, prior THA reported.  Rule out fracture. COVID 19 - with fever, leukocytosis.  Fatigue and malaise present.  On room air. Low procalcitonin lever. AKI with metabolic acidosis- likely prerenal. Recent rehab stay for cocaine use. Completing day 3 of 3 remdesivir.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Delivery, Labour stimulation, Maternal exposure before pregnancy, SARS-CoV-2 test positive
Clinical narrative: 7/21--7/22  33y.o. At 40w0d by L=8wk sono.  Pt reports feeling contractions since having her membranes stripped at OB appt this morning, she was 2cm. 7/21 SVD healthy baby. Ok for home today Instructions and call parameters and follow up reviewed. covid precautions and encouraged partner to test and isolate for 5 days
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound antenatal screen, Uterine contractions during pregnancy
Clinical narrative: 7/21--7/22  33y.o. At 40w0d by L=8wk sono.  Pt reports feeling contractions since having her membranes stripped at OB appt this morning, she was 2cm. 7/21 SVD healthy baby. Ok for home today Instructions and call parameters and follow up reviewed. covid precautions and encouraged partner to test and isolate for 5 days
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain lower, Back pain, Blood calcium normal, COVID-19, Computerised tomogram abnormal
Clinical narrative: 7/26--8/2 50 y/o with a h/o CHF sarcoidosis, asthma, HTN, DM came in complaining of left lower back and left lower quadrant abdominal pain, onset one day prior to arrival. With associated polyuria, NV. Additionally, complained of productive cough, nasal congestion, and SOB. CT showed multiple bilateral calculi, with the largest being a 8 mm stone in the L ureter. Patient brought to surgery by Urology and had a cystoscopy with left ureteral stent placement. Copious amounts of pus was drained after stent placement. Patient was started on IV NS, Morphone, and Azo prn. Zofran was available for nausea and we started patient of low oxalate diet. Ca was WNL, Vit D 25 was low, but Vit D 50,000 U qweek was dc'd. Pain regimen was transitioned to Toradol, Norco, and Dilaudid. Patient did not have further urinary sx. Was instructed to follow up with Urology outpatient for stent removal and was sent home on Naproxen BID and short course of Norco.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cystoscopy, Drainage, Dyspnoea, Lithiasis, Medical diet
Clinical narrative: 7/26--8/2 50 y/o with a h/o CHF sarcoidosis, asthma, HTN, DM came in complaining of left lower back and left lower quadrant abdominal pain, onset one day prior to arrival. With associated polyuria, NV. Additionally, complained of productive cough, nasal congestion, and SOB. CT showed multiple bilateral calculi, with the largest being a 8 mm stone in the L ureter. Patient brought to surgery by Urology and had a cystoscopy with left ureteral stent placement. Copious amounts of pus was drained after stent placement. Patient was started on IV NS, Morphone, and Azo prn. Zofran was available for nausea and we started patient of low oxalate diet. Ca was WNL, Vit D 25 was low, but Vit D 50,000 U qweek was dc'd. Pain regimen was transitioned to Toradol, Norco, and Dilaudid. Patient did not have further urinary sx. Was instructed to follow up with Urology outpatient for stent removal and was sent home on Naproxen BID and short course of Norco.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nasal congestion, Nausea, Polyuria, Productive cough, Purulent discharge
Clinical narrative: 7/26--8/2 50 y/o with a h/o CHF sarcoidosis, asthma, HTN, DM came in complaining of left lower back and left lower quadrant abdominal pain, onset one day prior to arrival. With associated polyuria, NV. Additionally, complained of productive cough, nasal congestion, and SOB. CT showed multiple bilateral calculi, with the largest being a 8 mm stone in the L ureter. Patient brought to surgery by Urology and had a cystoscopy with left ureteral stent placement. Copious amounts of pus was drained after stent placement. Patient was started on IV NS, Morphone, and Azo prn. Zofran was available for nausea and we started patient of low oxalate diet. Ca was WNL, Vit D 25 was low, but Vit D 50,000 U qweek was dc'd. Pain regimen was transitioned to Toradol, Norco, and Dilaudid. Patient did not have further urinary sx. Was instructed to follow up with Urology outpatient for stent removal and was sent home on Naproxen BID and short course of Norco.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Ureteral stent insertion, Ureterolithiasis, Vitamin D decreased, Vomiting
Clinical narrative: 7/26--8/2 50 y/o with a h/o CHF sarcoidosis, asthma, HTN, DM came in complaining of left lower back and left lower quadrant abdominal pain, onset one day prior to arrival. With associated polyuria, NV. Additionally, complained of productive cough, nasal congestion, and SOB. CT showed multiple bilateral calculi, with the largest being a 8 mm stone in the L ureter. Patient brought to surgery by Urology and had a cystoscopy with left ureteral stent placement. Copious amounts of pus was drained after stent placement. Patient was started on IV NS, Morphone, and Azo prn. Zofran was available for nausea and we started patient of low oxalate diet. Ca was WNL, Vit D 25 was low, but Vit D 50,000 U qweek was dc'd. Pain regimen was transitioned to Toradol, Norco, and Dilaudid. Patient did not have further urinary sx. Was instructed to follow up with Urology outpatient for stent removal and was sent home on Naproxen BID and short course of Norco.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal X-ray, Abdominal pain, COVID-19, Constipation, Culture urine negative
Clinical narrative: 7/26--7/27 6y.o. female with PMH of COVID in early June and constipation who presented with abdominal pain few hours prior to presentation on 7/25/2022 evening. Patient was diagnosed with constipation by PCP 3 weeks ago and was prescribed Miralax half a cup a day. Since then she has been having intermittent abdominal pain but recently it increased in intensity. She presented to ER on Thursday (7/21/22) for similar complain and was discharged after observation for several hours. UA and Urine culture was sent at the time which was negative for any signs of UTI. However, last night she endorses significant abdominal pain and was uncomfortable regardless of position, thus mother brought her to the ER again. She also has 3 episodes of NBNB vomiting (1 large, 2 small). She had had no more vomiting since. Her last bowel movement was yesterday, happened 3x, has soft consistency, but per mother was very small, small balls" In the EC her CMP, CBC, and UA were unremarkable. An ultrasound of the appendix did not visualize the appendix. Her abdominal xray showed scattered gas in the small and large bowel without pathologic distension, and no signs of obstruction or free air. She received a NS bolus, zofran, and enema. She only had a few flecks of stool that came out after the enema so she was admitted for bowel cleanout. The initial plan was for her to receive Golytely through an NGT, however after it was placed imaging to assess the location of the NGT it was found that it needed to be advanced another 10 cm. The patient then pulled out her NGT so the decision was made to trial oral golytely. Overnight she tolerated 50 mL of Golytely every hour. Her Golytely was then titrated up to goal rate to 14 ounces / hour which she continued until her bowel movements were nearly clear. She was maintained on IVF while she was taking Golytely. She was discharged home with the guidance to increase miralax to 1 cap per day and follow up with pediatrician to titrate dose to one full soft bowel movement per day.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Discomfort, Enema administration, Flatulence, Full blood count normal, Gastrointestinal tube insertion
Clinical narrative: 7/26--7/27 6y.o. female with PMH of COVID in early June and constipation who presented with abdominal pain few hours prior to presentation on 7/25/2022 evening. Patient was diagnosed with constipation by PCP 3 weeks ago and was prescribed Miralax half a cup a day. Since then she has been having intermittent abdominal pain but recently it increased in intensity. She presented to ER on Thursday (7/21/22) for similar complain and was discharged after observation for several hours. UA and Urine culture was sent at the time which was negative for any signs of UTI. However, last night she endorses significant abdominal pain and was uncomfortable regardless of position, thus mother brought her to the ER again. She also has 3 episodes of NBNB vomiting (1 large, 2 small). She had had no more vomiting since. Her last bowel movement was yesterday, happened 3x, has soft consistency, but per mother was very small, small balls" In the EC her CMP, CBC, and UA were unremarkable. An ultrasound of the appendix did not visualize the appendix. Her abdominal xray showed scattered gas in the small and large bowel without pathologic distension, and no signs of obstruction or free air. She received a NS bolus, zofran, and enema. She only had a few flecks of stool that came out after the enema so she was admitted for bowel cleanout. The initial plan was for her to receive Golytely through an NGT, however after it was placed imaging to assess the location of the NGT it was found that it needed to be advanced another 10 cm. The patient then pulled out her NGT so the decision was made to trial oral golytely. Overnight she tolerated 50 mL of Golytely every hour. Her Golytely was then titrated up to goal rate to 14 ounces / hour which she continued until her bowel movements were nearly clear. She was maintained on IVF while she was taking Golytely. She was discharged home with the guidance to increase miralax to 1 cap per day and follow up with pediatrician to titrate dose to one full soft bowel movement per day.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Metabolic function test normal, SARS-CoV-2 test positive, Ultrasound abdomen abnormal, Urine analysis normal, Vomiting
Clinical narrative: 7/26--7/27 6y.o. female with PMH of COVID in early June and constipation who presented with abdominal pain few hours prior to presentation on 7/25/2022 evening. Patient was diagnosed with constipation by PCP 3 weeks ago and was prescribed Miralax half a cup a day. Since then she has been having intermittent abdominal pain but recently it increased in intensity. She presented to ER on Thursday (7/21/22) for similar complain and was discharged after observation for several hours. UA and Urine culture was sent at the time which was negative for any signs of UTI. However, last night she endorses significant abdominal pain and was uncomfortable regardless of position, thus mother brought her to the ER again. She also has 3 episodes of NBNB vomiting (1 large, 2 small). She had had no more vomiting since. Her last bowel movement was yesterday, happened 3x, has soft consistency, but per mother was very small, small balls" In the EC her CMP, CBC, and UA were unremarkable. An ultrasound of the appendix did not visualize the appendix. Her abdominal xray showed scattered gas in the small and large bowel without pathologic distension, and no signs of obstruction or free air. She received a NS bolus, zofran, and enema. She only had a few flecks of stool that came out after the enema so she was admitted for bowel cleanout. The initial plan was for her to receive Golytely through an NGT, however after it was placed imaging to assess the location of the NGT it was found that it needed to be advanced another 10 cm. The patient then pulled out her NGT so the decision was made to trial oral golytely. Overnight she tolerated 50 mL of Golytely every hour. Her Golytely was then titrated up to goal rate to 14 ounces / hour which she continued until her bowel movements were nearly clear. She was maintained on IVF while she was taking Golytely. She was discharged home with the guidance to increase miralax to 1 cap per day and follow up with pediatrician to titrate dose to one full soft bowel movement per day.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, COVID-19, Caesarean section, Delivery, Maternal exposure before pregnancy
Clinical narrative: 7/16 - 7/19: 35-year-old G5P0312 at 37w2d by 8 week sono. Patient reported feeling significant vaginal and pelvic pressure getting worse over a few hours. She felt abdominal tightening, which she thought were contractions. Denied vaginal leaking or bleeding. Proceeded w/emergent C-section on 7/18. Baby delivered and healthy. Discharged home.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Pelvic discomfort, SARS-CoV-2 test positive, Uterine contractions during pregnancy, Vulvovaginal discomfort
Clinical narrative: 7/16 - 7/19: 35-year-old G5P0312 at 37w2d by 8 week sono. Patient reported feeling significant vaginal and pelvic pressure getting worse over a few hours. She felt abdominal tightening, which she thought were contractions. Denied vaginal leaking or bleeding. Proceeded w/emergent C-section on 7/18. Baby delivered and healthy. Discharged home.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site pain
Clinical narrative: HE CAME TODAY ON 08/05/2022 AND INFORMED US THAT AFTER GETTING VACCINE IN MAY/16/2021 HE HAS PAIN AT INJECTION SITE AND HIS DOCTOR INSISTED HIM TO INFORM PHARMACY. HE IS CLAIMIN THAT PAIN IS DURETO CONTENT OF THE VACCINE
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia, Dyspnoea
Clinical narrative: 7/25--7/27 76y.o. male who was admitted to the hospital with shortness of breath and COVID-19 pneumonia.  Medical problems treated during this admission are detailed below:  Acute hypoxic respiratory failure due to COVID-19 pneumonia - Tested positive on 7/22, with onset of symptoms 7/20. Vaccinated but not boosted. History of CLL. Mild O2 requirement to 2-3L during admission with evidence of pneumonia seen on CTA pulmonary. Infectious disease consulted during admission and recommended remdesivir, which patient declined. He was able to be weaned off O2 and home O2 evaluation did not reveal need for home oxygen.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 7/25--7/27 76y.o. male who was admitted to the hospital with shortness of breath and COVID-19 pneumonia.  Medical problems treated during this admission are detailed below:  Acute hypoxic respiratory failure due to COVID-19 pneumonia - Tested positive on 7/22, with onset of symptoms 7/20. Vaccinated but not boosted. History of CLL. Mild O2 requirement to 2-3L during admission with evidence of pneumonia seen on CTA pulmonary. Infectious disease consulted during admission and recommended remdesivir, which patient declined. He was able to be weaned off O2 and home O2 evaluation did not reveal need for home oxygen.
Age: 18.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Condition aggravated, Depression, Nasal congestion, SARS-CoV-2 test positive
Clinical narrative: 7/15-7/20 19y.o. male with history of depression, anxiety, aggressive behavior, substance abuse, previous suicide attempt who presented to the ED on 7/15 for worsening depression, suicide ideation and polysubstance abuse. He uses tobacco, marijuana and alcohol 3 times per week. He was previously taking Xanax, but stopped about one month ago. He was previously on antidepressants but is no longer taking them.  He tested positive for COVID on 7/4/22. He had nasal congestion for one day, no other symptoms. No chest pain, dyspnea, cough, abd pain, n/v.  In the hospital his COVID precautions were lifted once his quarantine period finished. After this, he was transferred to IP psych in stable condition.
Age: 18.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Substance abuse, Suicidal ideation
Clinical narrative: 7/15-7/20 19y.o. male with history of depression, anxiety, aggressive behavior, substance abuse, previous suicide attempt who presented to the ED on 7/15 for worsening depression, suicide ideation and polysubstance abuse. He uses tobacco, marijuana and alcohol 3 times per week. He was previously taking Xanax, but stopped about one month ago. He was previously on antidepressants but is no longer taking them.  He tested positive for COVID on 7/4/22. He had nasal congestion for one day, no other symptoms. No chest pain, dyspnea, cough, abd pain, n/v.  In the hospital his COVID precautions were lifted once his quarantine period finished. After this, he was transferred to IP psych in stable condition.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Angiogram abnormal, Angiogram pulmonary abnormal, Anticoagulant therapy, Asthenia
Clinical narrative: 7/20--currently admitted 84y.o. female with a PMH significant for atrial fibrillation, metastatic ovarian cancer on chemotherapy, pulmonary hypertension, HFpEF, who was recently hospitalized for COVID pneumonia 7/20, who presents with shortness of breath, weakness. During previous admission, patient was treated with loading dose of remdesivir, her oxygen saturations remained appropriate, and she was discharged. Patient's respiratory status began to deteriorate and she became progressively more weak with watery diarrhea and fever at home. Given her worsening respiratory status, her daughter-in-law and son felt as if they could no longer care for her appropriately, and brought her to the hospital to be evaluated. In the ED, lab work was notable for elevated troponin, elevated inflammatory markers, and pancytopenia. CXR was obtained. EKG with normal sinus rhythm with some ST-T wave depressions in leads II, III, to aVF. She was then admitted to the Medicine team for further evaluation and management of shortness of breath and weakness. Remdesivir and antibiotics 5 day courses were completed. CTA confirmed subsegmental pulmonary embolism in the right posterior lower lobe. Patient was transfused 1 unit of platelets followed by IV heparin initiation. 2D echo was notable for EF 40%, mild mitral and tricuspid regurgitation, multiple wall motion abnormalities, and left pleural effusion. Coreg 3.125 mg BID was started. Sotalol was switched to amiodarone given reduced EF. On 07/27, patient had new onset left sided abdominal pain with significant decrease in Hgb and BP secondary to retroperitoneal bleed confirmed by CTA.  IV heparin was immediately discontinued. 1 L bolus and 500 mL bolus were given as well as 2 units PRBCs. Interventional radiology embolized bilateral lumbar arteries. Hemoglobin stabilized around 7.5. Patient was initiated on Lovenox. Hematology is recommending that she be maintained on subcutaneous Lovenox 40 mg upon discharge for prophylaxis. Patient with persistent urinary retention while admitted and was thought to be associated with her mirabegron which was discontinued. She continued to have urinary retention and a foley was placed on 8/1 and urology was consulted for their recommendations. A bilateral lower extremity doppler was ordered to determine if patient needs an IVC filter. PT/OT recommend patient be discharged to SAR when medically stable. Patient has been non ambulatory while admitted secondary to deconditioning after being diagnosed with COVID.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Bladder catheterisation, Blood pressure decreased, COVID-19, COVID-19 pneumonia, Chest X-ray
Clinical narrative: 7/20--currently admitted 84y.o. female with a PMH significant for atrial fibrillation, metastatic ovarian cancer on chemotherapy, pulmonary hypertension, HFpEF, who was recently hospitalized for COVID pneumonia 7/20, who presents with shortness of breath, weakness. During previous admission, patient was treated with loading dose of remdesivir, her oxygen saturations remained appropriate, and she was discharged. Patient's respiratory status began to deteriorate and she became progressively more weak with watery diarrhea and fever at home. Given her worsening respiratory status, her daughter-in-law and son felt as if they could no longer care for her appropriately, and brought her to the hospital to be evaluated. In the ED, lab work was notable for elevated troponin, elevated inflammatory markers, and pancytopenia. CXR was obtained. EKG with normal sinus rhythm with some ST-T wave depressions in leads II, III, to aVF. She was then admitted to the Medicine team for further evaluation and management of shortness of breath and weakness. Remdesivir and antibiotics 5 day courses were completed. CTA confirmed subsegmental pulmonary embolism in the right posterior lower lobe. Patient was transfused 1 unit of platelets followed by IV heparin initiation. 2D echo was notable for EF 40%, mild mitral and tricuspid regurgitation, multiple wall motion abnormalities, and left pleural effusion. Coreg 3.125 mg BID was started. Sotalol was switched to amiodarone given reduced EF. On 07/27, patient had new onset left sided abdominal pain with significant decrease in Hgb and BP secondary to retroperitoneal bleed confirmed by CTA.  IV heparin was immediately discontinued. 1 L bolus and 500 mL bolus were given as well as 2 units PRBCs. Interventional radiology embolized bilateral lumbar arteries. Hemoglobin stabilized around 7.5. Patient was initiated on Lovenox. Hematology is recommending that she be maintained on subcutaneous Lovenox 40 mg upon discharge for prophylaxis. Patient with persistent urinary retention while admitted and was thought to be associated with her mirabegron which was discontinued. She continued to have urinary retention and a foley was placed on 8/1 and urology was consulted for their recommendations. A bilateral lower extremity doppler was ordered to determine if patient needs an IVC filter. PT/OT recommend patient be discharged to SAR when medically stable. Patient has been non ambulatory while admitted secondary to deconditioning after being diagnosed with COVID.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Diarrhoea, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST-T segment depression
Clinical narrative: 7/20--currently admitted 84y.o. female with a PMH significant for atrial fibrillation, metastatic ovarian cancer on chemotherapy, pulmonary hypertension, HFpEF, who was recently hospitalized for COVID pneumonia 7/20, who presents with shortness of breath, weakness. During previous admission, patient was treated with loading dose of remdesivir, her oxygen saturations remained appropriate, and she was discharged. Patient's respiratory status began to deteriorate and she became progressively more weak with watery diarrhea and fever at home. Given her worsening respiratory status, her daughter-in-law and son felt as if they could no longer care for her appropriately, and brought her to the hospital to be evaluated. In the ED, lab work was notable for elevated troponin, elevated inflammatory markers, and pancytopenia. CXR was obtained. EKG with normal sinus rhythm with some ST-T wave depressions in leads II, III, to aVF. She was then admitted to the Medicine team for further evaluation and management of shortness of breath and weakness. Remdesivir and antibiotics 5 day courses were completed. CTA confirmed subsegmental pulmonary embolism in the right posterior lower lobe. Patient was transfused 1 unit of platelets followed by IV heparin initiation. 2D echo was notable for EF 40%, mild mitral and tricuspid regurgitation, multiple wall motion abnormalities, and left pleural effusion. Coreg 3.125 mg BID was started. Sotalol was switched to amiodarone given reduced EF. On 07/27, patient had new onset left sided abdominal pain with significant decrease in Hgb and BP secondary to retroperitoneal bleed confirmed by CTA.  IV heparin was immediately discontinued. 1 L bolus and 500 mL bolus were given as well as 2 units PRBCs. Interventional radiology embolized bilateral lumbar arteries. Hemoglobin stabilized around 7.5. Patient was initiated on Lovenox. Hematology is recommending that she be maintained on subcutaneous Lovenox 40 mg upon discharge for prophylaxis. Patient with persistent urinary retention while admitted and was thought to be associated with her mirabegron which was discontinued. She continued to have urinary retention and a foley was placed on 8/1 and urology was consulted for their recommendations. A bilateral lower extremity doppler was ordered to determine if patient needs an IVC filter. PT/OT recommend patient be discharged to SAR when medically stable. Patient has been non ambulatory while admitted secondary to deconditioning after being diagnosed with COVID.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Gait inability, Haemoglobin decreased, Inflammatory marker increased, Laboratory test abnormal, Lumbar artery embolisation
Clinical narrative: 7/20--currently admitted 84y.o. female with a PMH significant for atrial fibrillation, metastatic ovarian cancer on chemotherapy, pulmonary hypertension, HFpEF, who was recently hospitalized for COVID pneumonia 7/20, who presents with shortness of breath, weakness. During previous admission, patient was treated with loading dose of remdesivir, her oxygen saturations remained appropriate, and she was discharged. Patient's respiratory status began to deteriorate and she became progressively more weak with watery diarrhea and fever at home. Given her worsening respiratory status, her daughter-in-law and son felt as if they could no longer care for her appropriately, and brought her to the hospital to be evaluated. In the ED, lab work was notable for elevated troponin, elevated inflammatory markers, and pancytopenia. CXR was obtained. EKG with normal sinus rhythm with some ST-T wave depressions in leads II, III, to aVF. She was then admitted to the Medicine team for further evaluation and management of shortness of breath and weakness. Remdesivir and antibiotics 5 day courses were completed. CTA confirmed subsegmental pulmonary embolism in the right posterior lower lobe. Patient was transfused 1 unit of platelets followed by IV heparin initiation. 2D echo was notable for EF 40%, mild mitral and tricuspid regurgitation, multiple wall motion abnormalities, and left pleural effusion. Coreg 3.125 mg BID was started. Sotalol was switched to amiodarone given reduced EF. On 07/27, patient had new onset left sided abdominal pain with significant decrease in Hgb and BP secondary to retroperitoneal bleed confirmed by CTA.  IV heparin was immediately discontinued. 1 L bolus and 500 mL bolus were given as well as 2 units PRBCs. Interventional radiology embolized bilateral lumbar arteries. Hemoglobin stabilized around 7.5. Patient was initiated on Lovenox. Hematology is recommending that she be maintained on subcutaneous Lovenox 40 mg upon discharge for prophylaxis. Patient with persistent urinary retention while admitted and was thought to be associated with her mirabegron which was discontinued. She continued to have urinary retention and a foley was placed on 8/1 and urology was consulted for their recommendations. A bilateral lower extremity doppler was ordered to determine if patient needs an IVC filter. PT/OT recommend patient be discharged to SAR when medically stable. Patient has been non ambulatory while admitted secondary to deconditioning after being diagnosed with COVID.