chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Dyspnoea exertional, Electrocardiogram abnormal, Emphysema, Eosinophil count decreased
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Eosinophil percentage, Fibrin D dimer increased, Full blood count abnormal, Glomerular filtration rate normal, Glucose urine absent
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Gynaecomastia, Haematocrit decreased, Haemoglobin decreased, Haemolysis, Hypervolaemia
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Immature granulocyte count, Immature granulocyte count increased, Infarction, Lung disorder, Lung opacity
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphocyte count, Lymphocyte percentage decreased, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Mean platelet volume increased, Metabolic function test abnormal, Monocyte count increased, Monocyte percentage, Neutrophil count increased
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Neutrophil percentage increased, Nitrite urine absent, Oedema peripheral, Platelet count normal, Positive airway pressure therapy
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Procalcitonin normal, Protein total decreased, Protein urine present, Pyrexia, Red blood cell count decreased
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Red blood cell nucleated morphology, Red blood cells urine positive, Red cell distribution width decreased, SARS-CoV-2 test positive, Scan with contrast abnormal
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Sepsis, Spinal osteoarthritis, Staphylococcus test, Ultrasound Doppler normal, Urinary casts
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary sediment present, Urine analysis abnormal, Urine ketone body absent, Urobilinogen urine increased, White blood cell count increased
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cells urine negative, pH urine normal
Clinical narrative: Patient is a 79 y.o. male who presents today with worsening shortness of breath and cough.  The patient has a pertinent medical history of chronic obstructive pulmonary disease on 3 L nasal cannula baseline per patient, systolic and diastolic heart failure with EF 54% in Dec 2020, coronary artery disease, PAD, hypertension, and hyperlipidemia.  The patient states his symptoms started roughly 3-4 days ago that included shortness of breath on exertion and cough.  The symptoms progressively have gotten worse over these previous days so he presented to the ER.  He was febrile in the ER and a code sepsis was started and he was given a 1000 mL fluid bolus.  He was requiring BiPAP support 12/6 100%. He subsequently tested positive for COVID so code sepsis was stopped.  Chest x-ray shows interstitial opacities at the lung bases.  Procalcitonin was 0.24.  He was vaccinated for COVID with Pfizer on 05/27/2021 and 06/17/2021.   The patient was admitted to the hospitalist team for further medical management.  He endorses fever, shortness of breath, cough.  He denies sputum production, nausea, vomiting, diarrhea, dizziness, lightheadedness, headaches, chest pain.  The plan will be to start dexamethasone and remdesivir for COVID pneumonia.  Will obtain a D-dimer at this time and can consider CTA of the chest if elevated.  Given her normal WBC and procalcitonin I have low suspicion for concurrent bacterial pneumonia.  He he is currently on BiPAP 12/6 at 35% with plan to wean to high-flow nasal cannula with assistance from respiratory therapy.  Given heart failure history and large fluid bolus in the ER, patient may need intravenous Lasix for hypervolemia and significant bilateral lower extremity edema.  I updated the patient on the plan of care and all questions and concerns were addressed
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Amnesia, Asthma, Dyspnoea, Facial pain, Fatigue
Clinical narrative: Memory loss, fatigue, brain fog, rhinitis, asthma (wheezing, shortness of breath) Arm, neck, and facial pain
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal, Neck pain, Pain in extremity, Rhinitis, Wheezing
Clinical narrative: Memory loss, fatigue, brain fog, rhinitis, asthma (wheezing, shortness of breath) Arm, neck, and facial pain
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Error: Wrong Dose of Vaccine - Too Low-
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Feeling of body temperature change, Presyncope
Clinical narrative: Vaso/vagal response with anxiety, hot/cold Encouraged laying on the floor with feet on chair but anxiety prevented a prolonged laying time Hydrated with water, spoke calmly and tried to engage patient in conversation Gave 25mg diphenhydramine at 15 minute intervals twice. Decided to call the ambulance
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Urticaria
Clinical narrative: Next day hives, itchy skin, urticaria. Non-responsive to allergy medication
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram normal, Dizziness, Electroencephalogram, Vertigo
Clinical narrative: Extreme dizziness and vertigo , 1 week after 2nd dose. Urgent care and ER trip, still had extremem vertigo present on 11/16
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dysphonia, Respiratory tract congestion
Clinical narrative: Congestion in chest, coughing, hoarse. Took mucinex.  Sudafed.  Drank tea with honey. Still have congestion today (11/16/2021)
Age: 29.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hypotension, Presyncope
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Additional Details: Pt had vasovagal response 2 minutes after administration. Pt with hx of fainting with injections/medical procedures. Fainting episode lasted <5 seconds. Pt did not fall. No head injuries. BP immediately after incident 90/50, HR 50. After drinking water, taking a sugar tablet, and laying supine for 15 minutes, BP was 110/70, HR 70. Pt states he felt fine at that point. Normal gait, coodination observed. Pt alert and oriented prior to discharge. Escorted home by girlfriend. Follow-up call sched
Age: 29.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope, Unresponsive to stimuli
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Additional Details: Pt had vasovagal response 2 minutes after administration. Pt with hx of fainting with injections/medical procedures. Fainting episode lasted <5 seconds. Pt did not fall. No head injuries. BP immediately after incident 90/50, HR 50. After drinking water, taking a sugar tablet, and laying supine for 15 minutes, BP was 110/70, HR 70. Pt states he felt fine at that point. Normal gait, coodination observed. Pt alert and oriented prior to discharge. Escorted home by girlfriend. Follow-up call sched
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Cough, Dyspnoea, Influenza A virus test negative, Influenza B virus test
Clinical narrative: Patient came to hospital on 11/12/21 with worsening cough and SOB.  SpO2 at health clinic was 88% on RA.  Has since been hospitalized and is on 6L of O2 by NC.  Patient has had three doses of Moderna Vaccine (booster completed 11/3/21).
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Influenza virus test negative, SARS-CoV-2 test positive
Clinical narrative: Patient came to hospital on 11/12/21 with worsening cough and SOB.  SpO2 at health clinic was 88% on RA.  Has since been hospitalized and is on 6L of O2 by NC.  Patient has had three doses of Moderna Vaccine (booster completed 11/3/21).
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Patient came to hospital on 11/12/21 with worsening cough and SOB.  SpO2 at health clinic was 88% on RA.  Has since been hospitalized and is on 6L of O2 by NC.  Patient has had three doses of Moderna Vaccine (booster completed 11/3/21).
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Sputum increased
Clinical narrative: Patient came to hospital on 11/12/21 with worsening cough and SOB.  SpO2 at health clinic was 88% on RA.  Has since been hospitalized and is on 6L of O2 by NC.  Patient has had three doses of Moderna Vaccine (booster completed 11/3/21).
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Headache, Injection site pain, Malaise, Myalgia
Clinical narrative: Nausea (almost vomited), headache, fever, chills, left arm pain at injection site, muscle aches and pain, general malaise through 15-Nov-2021. As of 16-Nov, he feels better but has a runny nose.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Pyrexia, Rhinorrhoea
Clinical narrative: Nausea (almost vomited), headache, fever, chills, left arm pain at injection site, muscle aches and pain, general malaise through 15-Nov-2021. As of 16-Nov, he feels better but has a runny nose.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary pain, Fatigue, Oedema peripheral, Tenderness
Clinical narrative: Approximately 7-9 hours after shot I had an achey pain in both armpits. The next morning (day2),  I woke up with a swollen left armpit (same side as shot) which was achey and tender to touch. Nothing on the right armpit. The next day (day 3)it became a bit larger (half a lemon size?) Today, Day 4, the swelling began to go down.    No other adverse side effects other than tiredness on Day 2.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Axillary pain, Hypoaesthesia
Clinical narrative: Everything felt normal till the third day my armpit started hurting in one specific area. When I put my arm down and twist back a little bit my veins hurt feels like needles poking my arm and if I raise my arm above my head my armpit starts to hurt. Once in awhile I get a sense of numbness on my left side where I got my shot from my ribs to my neck.
Age: 67.0
Sex: F
Vaccine: FLU4, PPV
Symptoms: Back pain, Musculoskeletal discomfort, Musculoskeletal pain, Nervousness, Pain
Clinical narrative: The patient works here in our store.  I administered both vaccines and the patient reported no issues at that time.  About 15 minutes later she came back over and reported terrible pain in the center of her back that radiated from her shoulder-blade area to the lower back.  I asked her if she was short of breath, if she felt her throat closing, was itchy, etc. and she reported no to all of those symptoms that would indicate anaphylaxis.  I had her sit down and took her blood pressure which was 141/81 and her HR was 78.  As she sat the pain subsided little by little and then she described it as feeling 'bruised.'  She described the pain as muscular not nerve-related. About another 15 minutes went by after sitting and she reported the pain was gone but just felt shaken up.  Later in the day she stopped by the pharmacy and only felt slight discomfort under her left shoulder blade.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Adrenal insufficiency, Angiogram pulmonary normal, Anion gap increased, Anxiety
Clinical narrative: 1. Shock likely hypovolemic  - presents with chest pain, shortness of breath, presyncope, shaking chills, all symptoms started in last 24 hours, hypotensive with systolic BP in 60s, BP still in 90-100s despite 3 lt IV fluids and 10 mcg levophed, afebrile, WBC normal, hemoglobin 11.3, no recent baseline, no active bleeding noted, lactate 1.9, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, troponin -ve x 1, pro BNP normal, LFTs and lipase normal, testing for influenza A/B and SARS-CoV2 negative,, UA no pyuria. Has AKI, EKG NSR, no st-t changes, low voltage QRS noted, CXR negative for acute findings, CTA chest, CT abdomen/pelvis, CT head and CT cervical spine negative. Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump  - based on this has shock likely hypovolemic due to DKA, septic shock seems unlikely due to absence of clear infection source, adrenal insufficiency is in differential especially if shock fails to respond to therapy  - continue IV levophed, start DKA protocol with IV insulin, received dose of ceftriaxone in ER, will monitor off abx for now, low threshold to start abx if spikes fevers or hypotension persists, trend troponins, monitor H&H, please f/u blood Cx and serum cortisol results 2. DKA (diabetic ketoacidosis)    - please see problem #1, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump, also elevated anion gap persists despite fluid resuscitation  - based on this has DKA, recent stress might be driving the DKA  - start DKA protocol with IV insulin, hold insulin pump while on IV insulin 3. AKI (acute kidney injury)  - serum creatinine 1.1 from baseline of 0.7-0.8, BUN 18, AKI is likely prerenal, continue IV fluids and levophed as above 4. Anemia  - hemoglobin 11.3, no recent levels available, denies active bleeding, MCV normal, will monitor H&H, consider further evaluation as appropriate 5. ANXIETY  - Has been on lot of stress lately as she had to get COVID vaccine, will start PRN ativan
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood creatinine normal, Blood culture negative, Blood glucose increased, Blood lactic acid decreased, Blood sodium decreased
Clinical narrative: 1. Shock likely hypovolemic  - presents with chest pain, shortness of breath, presyncope, shaking chills, all symptoms started in last 24 hours, hypotensive with systolic BP in 60s, BP still in 90-100s despite 3 lt IV fluids and 10 mcg levophed, afebrile, WBC normal, hemoglobin 11.3, no recent baseline, no active bleeding noted, lactate 1.9, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, troponin -ve x 1, pro BNP normal, LFTs and lipase normal, testing for influenza A/B and SARS-CoV2 negative,, UA no pyuria. Has AKI, EKG NSR, no st-t changes, low voltage QRS noted, CXR negative for acute findings, CTA chest, CT abdomen/pelvis, CT head and CT cervical spine negative. Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump  - based on this has shock likely hypovolemic due to DKA, septic shock seems unlikely due to absence of clear infection source, adrenal insufficiency is in differential especially if shock fails to respond to therapy  - continue IV levophed, start DKA protocol with IV insulin, received dose of ceftriaxone in ER, will monitor off abx for now, low threshold to start abx if spikes fevers or hypotension persists, trend troponins, monitor H&H, please f/u blood Cx and serum cortisol results 2. DKA (diabetic ketoacidosis)    - please see problem #1, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump, also elevated anion gap persists despite fluid resuscitation  - based on this has DKA, recent stress might be driving the DKA  - start DKA protocol with IV insulin, hold insulin pump while on IV insulin 3. AKI (acute kidney injury)  - serum creatinine 1.1 from baseline of 0.7-0.8, BUN 18, AKI is likely prerenal, continue IV fluids and levophed as above 4. Anemia  - hemoglobin 11.3, no recent levels available, denies active bleeding, MCV normal, will monitor H&H, consider further evaluation as appropriate 5. ANXIETY  - Has been on lot of stress lately as she had to get COVID vaccine, will start PRN ativan
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood urea normal, Chest X-ray normal, Chest pain, Chills, Computerised tomogram abdomen normal
Clinical narrative: 1. Shock likely hypovolemic  - presents with chest pain, shortness of breath, presyncope, shaking chills, all symptoms started in last 24 hours, hypotensive with systolic BP in 60s, BP still in 90-100s despite 3 lt IV fluids and 10 mcg levophed, afebrile, WBC normal, hemoglobin 11.3, no recent baseline, no active bleeding noted, lactate 1.9, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, troponin -ve x 1, pro BNP normal, LFTs and lipase normal, testing for influenza A/B and SARS-CoV2 negative,, UA no pyuria. Has AKI, EKG NSR, no st-t changes, low voltage QRS noted, CXR negative for acute findings, CTA chest, CT abdomen/pelvis, CT head and CT cervical spine negative. Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump  - based on this has shock likely hypovolemic due to DKA, septic shock seems unlikely due to absence of clear infection source, adrenal insufficiency is in differential especially if shock fails to respond to therapy  - continue IV levophed, start DKA protocol with IV insulin, received dose of ceftriaxone in ER, will monitor off abx for now, low threshold to start abx if spikes fevers or hypotension persists, trend troponins, monitor H&H, please f/u blood Cx and serum cortisol results 2. DKA (diabetic ketoacidosis)    - please see problem #1, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump, also elevated anion gap persists despite fluid resuscitation  - based on this has DKA, recent stress might be driving the DKA  - start DKA protocol with IV insulin, hold insulin pump while on IV insulin 3. AKI (acute kidney injury)  - serum creatinine 1.1 from baseline of 0.7-0.8, BUN 18, AKI is likely prerenal, continue IV fluids and levophed as above 4. Anemia  - hemoglobin 11.3, no recent levels available, denies active bleeding, MCV normal, will monitor H&H, consider further evaluation as appropriate 5. ANXIETY  - Has been on lot of stress lately as she had to get COVID vaccine, will start PRN ativan
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram head normal, Computerised tomogram spine, Diabetic ketoacidosis, Dyspnoea, Electrocardiogram normal
Clinical narrative: 1. Shock likely hypovolemic  - presents with chest pain, shortness of breath, presyncope, shaking chills, all symptoms started in last 24 hours, hypotensive with systolic BP in 60s, BP still in 90-100s despite 3 lt IV fluids and 10 mcg levophed, afebrile, WBC normal, hemoglobin 11.3, no recent baseline, no active bleeding noted, lactate 1.9, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, troponin -ve x 1, pro BNP normal, LFTs and lipase normal, testing for influenza A/B and SARS-CoV2 negative,, UA no pyuria. Has AKI, EKG NSR, no st-t changes, low voltage QRS noted, CXR negative for acute findings, CTA chest, CT abdomen/pelvis, CT head and CT cervical spine negative. Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump  - based on this has shock likely hypovolemic due to DKA, septic shock seems unlikely due to absence of clear infection source, adrenal insufficiency is in differential especially if shock fails to respond to therapy  - continue IV levophed, start DKA protocol with IV insulin, received dose of ceftriaxone in ER, will monitor off abx for now, low threshold to start abx if spikes fevers or hypotension persists, trend troponins, monitor H&H, please f/u blood Cx and serum cortisol results 2. DKA (diabetic ketoacidosis)    - please see problem #1, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump, also elevated anion gap persists despite fluid resuscitation  - based on this has DKA, recent stress might be driving the DKA  - start DKA protocol with IV insulin, hold insulin pump while on IV insulin 3. AKI (acute kidney injury)  - serum creatinine 1.1 from baseline of 0.7-0.8, BUN 18, AKI is likely prerenal, continue IV fluids and levophed as above 4. Anemia  - hemoglobin 11.3, no recent levels available, denies active bleeding, MCV normal, will monitor H&H, consider further evaluation as appropriate 5. ANXIETY  - Has been on lot of stress lately as she had to get COVID vaccine, will start PRN ativan
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Haematocrit increased, Haemoglobin decreased, Hypotension, Hypovolaemic shock, Influenza A virus test negative
Clinical narrative: 1. Shock likely hypovolemic  - presents with chest pain, shortness of breath, presyncope, shaking chills, all symptoms started in last 24 hours, hypotensive with systolic BP in 60s, BP still in 90-100s despite 3 lt IV fluids and 10 mcg levophed, afebrile, WBC normal, hemoglobin 11.3, no recent baseline, no active bleeding noted, lactate 1.9, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, troponin -ve x 1, pro BNP normal, LFTs and lipase normal, testing for influenza A/B and SARS-CoV2 negative,, UA no pyuria. Has AKI, EKG NSR, no st-t changes, low voltage QRS noted, CXR negative for acute findings, CTA chest, CT abdomen/pelvis, CT head and CT cervical spine negative. Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump  - based on this has shock likely hypovolemic due to DKA, septic shock seems unlikely due to absence of clear infection source, adrenal insufficiency is in differential especially if shock fails to respond to therapy  - continue IV levophed, start DKA protocol with IV insulin, received dose of ceftriaxone in ER, will monitor off abx for now, low threshold to start abx if spikes fevers or hypotension persists, trend troponins, monitor H&H, please f/u blood Cx and serum cortisol results 2. DKA (diabetic ketoacidosis)    - please see problem #1, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump, also elevated anion gap persists despite fluid resuscitation  - based on this has DKA, recent stress might be driving the DKA  - start DKA protocol with IV insulin, hold insulin pump while on IV insulin 3. AKI (acute kidney injury)  - serum creatinine 1.1 from baseline of 0.7-0.8, BUN 18, AKI is likely prerenal, continue IV fluids and levophed as above 4. Anemia  - hemoglobin 11.3, no recent levels available, denies active bleeding, MCV normal, will monitor H&H, consider further evaluation as appropriate 5. ANXIETY  - Has been on lot of stress lately as she had to get COVID vaccine, will start PRN ativan
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Influenza B virus test, Lipase normal, Liver function test normal, Mean cell volume normal, Metabolic acidosis
Clinical narrative: 1. Shock likely hypovolemic  - presents with chest pain, shortness of breath, presyncope, shaking chills, all symptoms started in last 24 hours, hypotensive with systolic BP in 60s, BP still in 90-100s despite 3 lt IV fluids and 10 mcg levophed, afebrile, WBC normal, hemoglobin 11.3, no recent baseline, no active bleeding noted, lactate 1.9, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, troponin -ve x 1, pro BNP normal, LFTs and lipase normal, testing for influenza A/B and SARS-CoV2 negative,, UA no pyuria. Has AKI, EKG NSR, no st-t changes, low voltage QRS noted, CXR negative for acute findings, CTA chest, CT abdomen/pelvis, CT head and CT cervical spine negative. Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump  - based on this has shock likely hypovolemic due to DKA, septic shock seems unlikely due to absence of clear infection source, adrenal insufficiency is in differential especially if shock fails to respond to therapy  - continue IV levophed, start DKA protocol with IV insulin, received dose of ceftriaxone in ER, will monitor off abx for now, low threshold to start abx if spikes fevers or hypotension persists, trend troponins, monitor H&H, please f/u blood Cx and serum cortisol results 2. DKA (diabetic ketoacidosis)    - please see problem #1, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump, also elevated anion gap persists despite fluid resuscitation  - based on this has DKA, recent stress might be driving the DKA  - start DKA protocol with IV insulin, hold insulin pump while on IV insulin 3. AKI (acute kidney injury)  - serum creatinine 1.1 from baseline of 0.7-0.8, BUN 18, AKI is likely prerenal, continue IV fluids and levophed as above 4. Anemia  - hemoglobin 11.3, no recent levels available, denies active bleeding, MCV normal, will monitor H&H, consider further evaluation as appropriate 5. ANXIETY  - Has been on lot of stress lately as she had to get COVID vaccine, will start PRN ativan
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Metabolic function test, N-terminal prohormone brain natriuretic peptide normal, Presyncope, SARS-CoV-2 test negative, Shock
Clinical narrative: 1. Shock likely hypovolemic  - presents with chest pain, shortness of breath, presyncope, shaking chills, all symptoms started in last 24 hours, hypotensive with systolic BP in 60s, BP still in 90-100s despite 3 lt IV fluids and 10 mcg levophed, afebrile, WBC normal, hemoglobin 11.3, no recent baseline, no active bleeding noted, lactate 1.9, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, troponin -ve x 1, pro BNP normal, LFTs and lipase normal, testing for influenza A/B and SARS-CoV2 negative,, UA no pyuria. Has AKI, EKG NSR, no st-t changes, low voltage QRS noted, CXR negative for acute findings, CTA chest, CT abdomen/pelvis, CT head and CT cervical spine negative. Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump  - based on this has shock likely hypovolemic due to DKA, septic shock seems unlikely due to absence of clear infection source, adrenal insufficiency is in differential especially if shock fails to respond to therapy  - continue IV levophed, start DKA protocol with IV insulin, received dose of ceftriaxone in ER, will monitor off abx for now, low threshold to start abx if spikes fevers or hypotension persists, trend troponins, monitor H&H, please f/u blood Cx and serum cortisol results 2. DKA (diabetic ketoacidosis)    - please see problem #1, labs indicate elevated anion gap metabolic acidosis, also has positive urine ketones and trace acetone in serum, Has been on lot of stress lately as she had to get COVID vaccine, has type 1 DM on insulin pump, also elevated anion gap persists despite fluid resuscitation  - based on this has DKA, recent stress might be driving the DKA  - start DKA protocol with IV insulin, hold insulin pump while on IV insulin 3. AKI (acute kidney injury)  - serum creatinine 1.1 from baseline of 0.7-0.8, BUN 18, AKI is likely prerenal, continue IV fluids and levophed as above 4. Anemia  - hemoglobin 11.3, no recent levels available, denies active bleeding, MCV normal, will monitor H&H, consider further evaluation as appropriate 5. ANXIETY  - Has been on lot of stress lately as she had to get COVID vaccine, will start PRN ativan